Provider Demographics
NPI:1215284666
Name:INTEGRATED INJURY MANAGEMENT SERVICES INC
Entity type:Organization
Organization Name:INTEGRATED INJURY MANAGEMENT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:800-515-4552
Mailing Address - Street 1:PO BOX 2367
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92516-2367
Mailing Address - Country:US
Mailing Address - Phone:800-515-4552
Mailing Address - Fax:800-515-4552
Practice Address - Street 1:2900 ADAMS ST
Practice Address - Street 2:C130
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-4335
Practice Address - Country:US
Practice Address - Phone:800-515-4552
Practice Address - Fax:800-515-4552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11970261QP2000X
HI1761261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy