Provider Demographics
NPI:1811208374
Name:HORIZON INTEGRATIVE MEDICINE
Entity type:Organization
Organization Name:HORIZON INTEGRATIVE MEDICINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MORISSETTE
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:404-952-9443
Mailing Address - Street 1:150 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9089
Mailing Address - Country:US
Mailing Address - Phone:404-952-9443
Mailing Address - Fax:
Practice Address - Street 1:150 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9089
Practice Address - Country:US
Practice Address - Phone:404-952-9443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORIZON INTEGRATIVE MEDICINE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty