Organization
INTEGRATIVE PHYSICAL MEDICINE OF LAKE MARY LLC
Active
Parent organization
INTEGRATIVE PHYSICAL MEDICINE HOLDING LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTEGRATIVE PHYSICAL MEDICINE HOLDING LLC
Authorized official
MARC OTT (PRESIDENT)
(407) 792-0705
Entity
Organization
Contact information
Practice address
1343 S INTERNATIONAL PKWY, LAKE MARY, FL 32746-1401
(407) 792-0705
(407) 792-0710
Mailing address
1343 S INTERNATIONAL PKWY, LAKE MARY, FL 32746-1401
(407) 792-0705
(407) 792-0710
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/19/2014
Last updated
06/01/2016
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