Provider Demographics
NPI:1154609329
Name:INTEGRATIVE HEALTH CONSULTING
Entity type:Organization
Organization Name:INTEGRATIVE HEALTH CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-221-1106
Mailing Address - Street 1:2620 E PROSPECT RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-9098
Mailing Address - Country:US
Mailing Address - Phone:970-221-1106
Mailing Address - Fax:
Practice Address - Street 1:2620 E PROSPECT RD
Practice Address - Street 2:SUITE 190
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-9098
Practice Address - Country:US
Practice Address - Phone:970-221-1106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO45840207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty