Organization
INTEGRATED MEDICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG HUNT (CHIEF EXECUTIVE OFFICER)
(570) 622-5455
Entity
Organization
Contact information
Practice address
48 TUNNEL RD STE 203, POTTSVILLE, PA 17901-3885
(570) 624-4777
Mailing address
82 TUNNEL RD, POTTSVILLE, PA 17901-3869
(570) 622-5455
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10077517400061
—
PA
Enumeration date
03/28/2018
Last updated
03/28/2018
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