Organization
INTEGRITY EXTENDED HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PALLAKI D RAVI MD (MEMBER)
(248) 660-5830
Entity
Organization
Contact information
Practice address
308 W MAPLE AVE, LANCASTER, KY 40444-1005
(248) 660-5830
(859) 224-2057
Mailing address
PO BOX 10, EUBANK, KY 42567-0010
(248) 660-5830
(859) 224-2057
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46290
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MPKY.0674-00
MED MAL
KY
Enumeration date
07/27/2017
Last updated
07/27/2017
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