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Organization
INTEGRATED MEDICAL GROUP, P.C.
Active
Organization
INTEGRATED MEDICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY WALSH (DIRECTOR OF OPERATIONS)
(570) 622-5455
Entity
Organization
Contact information
Practice address
45 S PINE ST, ELVERSON, PA 19520-9720
(570) 624-4777
(570) 624-4778
Mailing address
82 TUNNEL RD, POTTSVILLE, PA 17901-3869
(570) 622-5455
(570) 622-5493
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
NULL
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
06/03/2020
Last updated
06/03/2020
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