Provider Demographics
NPI:1306237300
Name:INTEGRATIVE PHYSICIAN SERVICES INC.
Entity type:Organization
Organization Name:INTEGRATIVE PHYSICIAN SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:800-362-4183
Mailing Address - Street 1:138 PALM COAST PKWY NE
Mailing Address - Street 2:SUITE 127
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8241
Mailing Address - Country:US
Mailing Address - Phone:800-362-4183
Mailing Address - Fax:386-456-3071
Practice Address - Street 1:4490 N US HIGHWAY 1
Practice Address - Street 2:SUITE 108
Practice Address - City:BUNNELL
Practice Address - State:FL
Practice Address - Zip Code:32110-4374
Practice Address - Country:US
Practice Address - Phone:800-362-4183
Practice Address - Fax:386-456-3071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11373111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Multi-Specialty