Organization
BEAUMONT INTEGRATED MEDICINE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL VANHOOSE ARNP (ADMINISTRATOR)
(859) 559-0804
Entity
Organization
Contact information
Practice address
989 GOVERNORS LN, LEXINGTON, KY 40513-1173
(859) 559-4272
Mailing address
7980 SOLUTION CTR, CHICAGO, IL 60677-7009
(859) 559-4272
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
36483
KY
Other
Enumeration date
08/29/2014
Last updated
09/16/2015
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