Provider Demographics
NPI:1811684921
Name:INTEGRATIVE WHOLE BODY HEALTH CENTER LLC
Entity type:Organization
Organization Name:INTEGRATIVE WHOLE BODY HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WENDI
Authorized Official - Middle Name:ROSEANNE
Authorized Official - Last Name:MEDVED
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:303-232-2600
Mailing Address - Street 1:780 SIMMS ST STE 102
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-4725
Mailing Address - Country:US
Mailing Address - Phone:303-232-2600
Mailing Address - Fax:866-651-7969
Practice Address - Street 1:780 SIMMS ST STE 102
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-4725
Practice Address - Country:US
Practice Address - Phone:303-232-2600
Practice Address - Fax:866-651-7969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, AmbulatoryGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty