Organization
INTEGRATIVE PHYSICAL MEDICINE OF LAKE MARY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC OTT (PRESIDENT)
(407) 977-3434
Entity
Organization
Contact information
Practice address
1343 S INTERNATIONAL PKWY, SUITE 1351-B, LAKE MARY, FL 32746-1401
(407) 792-0705
(407) 792-0710
Mailing address
1343 S INTERNATIONAL PKWY, SUITE 1351-B, LAKE MARY, FL 32746-1401
(407) 792-0705
(407) 792-0710
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/19/2012
Last updated
11/20/2012
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