# PINE HEIGHTS INTEGRATIVE HEALTH, LLC

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

## Provider details

- **NPI number:** 1861085607
- **Authorized official:** PHYLLIS BLACKWELL (OFFICE MANAGER)
- **Authorized official phone:** (301) 575-6549

## Contact information

- **Practice address:** 1001 PINE HEIGHTS AVE STE 304, BALTIMORE, MD 21229-5285
- **Practice address phone:** (240) 614-6369
- **Practice address fax:** (301) 476-0418
- **Mailing address:** 30 W GUDE DR STE 375, ROCKVILLE, MD 20850-4300
- **Mailing address phone:** (240) 614-6369
- **Mailing address fax:** (301) 545-0885

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | — | NULL | Yes |
| 111NR0400X | Rehabilitation Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 02/12/2021
- **Last updated:** 02/12/2021