Organization
INTEGRACARE LLC
Active
Organization
INTEGRACARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY CAMERON WALLACE (MANAGER)
(970) 977-6239
Entity
Organization
Contact information
Practice address
5300 W 29TH ST, GREELEY, CO 80634-8399
(970) 353-6800
(970) 506-4202
Mailing address
PO BOX 65, EDWARDS, CO 81632-0065
(970) 977-6239
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
—
—
225XG0600X
Gerontology Occupational Therapist
—
—
Other
Enumeration date
08/03/2012
Last updated
08/03/2012
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