Organization
INTEGRATIVE THERAPIES FOR CANCER & CHRONIC DISEASE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLLEEN TETZLAFF DNP (OWNER)
(207) 699-3838
Entity
Organization
Contact information
Practice address
222 AUBURN ST STE 103, PORTLAND, ME 04103-6005
(207) 699-3838
Mailing address
222 AUBURN ST STE 103, PORTLAND, ME 04103-6005
(207) 699-3838
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP548701
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432379199
—
ME
Enumeration date
06/23/2013
Last updated
05/22/2019
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