Provider Demographics
NPI:1992472419
Name:INSTITUTE FOR INTEGRATIVE THERAPIES
Entity type:Organization
Organization Name:INSTITUTE FOR INTEGRATIVE THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:651-280-8774
Mailing Address - Street 1:9300 HENNEPIN TOWN RD STE B
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-3072
Mailing Address - Country:US
Mailing Address - Phone:651-280-8774
Mailing Address - Fax:844-479-8458
Practice Address - Street 1:9300 HENNEPIN TOWN RD STE B
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-3072
Practice Address - Country:US
Practice Address - Phone:651-280-8774
Practice Address - Fax:844-479-8458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-23
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty