Organization
INTEGRATED PHYSICAL MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIK DANIEL STANTON (GENERAL MANAGER)
(616) 863-9482
Entity
Organization
Contact information
Practice address
6769 COURTLAND DR NE, SUITE 100, ROCKFORD, MI 49341-7242
(616) 863-9482
(616) 863-9486
Mailing address
6769 COURTLAND DR NE, SUITE 100, ROCKFORD, MI 49341-7242
(616) 863-9482
(616) 863-9486
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301059449
MI
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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