# FOUNDATIONS INTEGRATED MEDICAL & SPORTS HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770115578
- **Authorized official:** DR. THOMAS L MUNCY II DC (OWNER)
- **Authorized official phone:** (276) 591-5448

## Contact information

- **Practice address:** 300 MOORE ST STE B, BRISTOL, VA 24201-4495
- **Practice address phone:** (276) 591-5448
- **Practice address fax:** (276) 591-5447
- **Mailing address:** 300 MOORE ST STE B, BRISTOL, VA 24201-4495
- **Mailing address phone:** (276) 591-5448
- **Mailing address fax:** (276) 591-5447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/10/2020
- **Last updated:** 10/13/2023