Organization
ASHLAND INTEGRATED MEDICINE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL LEE VANHOOSE APRN (APRN/OWNER)
(606) 393-0110
Entity
Organization
Contact information
Practice address
155 W. CENTRAL AVENUE, ASHLAND, KY 41101-7364
(606) 393-0110
(606) 326-0114
Mailing address
155 W. CENTRAL AVENUE, ASHLAND, KY 41101-7364
(606) 393-0110
(606) 326-0114
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
5449
KY
208600000X
Surgery Physician
36483
KY
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
363L00000X
Nurse Practitioner
3006910
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100350560
—
KY
05
—
7100363920
—
KY
05
—
7100428120
—
KY
Enumeration date
08/26/2014
Last updated
11/30/2016
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