Organization
HAMBURG INTEGRATED MEDICINE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL VANHOOSE APRN (ADMINISTRATOR)
(859) 559-0804
Entity
Organization
Contact information
Practice address
1890 STAR SHOOT PKWY, SUITE 190, LEXINGTON, KY 40509-4566
(859) 963-1291
Mailing address
7968 SOLUTION CTR, CHICAGO, IL 60677-7009
(859) 963-1291
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
36483
KY
Other
Enumeration date
08/28/2014
Last updated
09/16/2015
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