Provider Demographics
NPI:1861813180
Name:INTEGRATIVE PRACTICE SOLUTIONS
Entity type:Organization
Organization Name:INTEGRATIVE PRACTICE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:910-620-6769
Mailing Address - Street 1:712 VILLAGE RD SW STE 101
Mailing Address - Street 2:
Mailing Address - City:SHALLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28470-3449
Mailing Address - Country:US
Mailing Address - Phone:910-755-5400
Mailing Address - Fax:910-755-5402
Practice Address - Street 1:1780 QUEEN ANNE
Practice Address - Street 2:SUITE 5
Practice Address - City:SUNSET BEACH
Practice Address - State:NC
Practice Address - Zip Code:28468-4392
Practice Address - Country:US
Practice Address - Phone:910-620-6769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-05
Last Update Date:2014-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP11150261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy