| Organization Name: | INTEGRATIVE HEALTH INSTITUTE LLC |
| NPI Number: | 1093060717 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRYAN R GLICK (OWNER) |
| Mailing Address: | 7659 E Pinnacle Peak Rd Ste 105 Scottsdale |
| State: | AZ US |
| Postal Code: | 852556297 |
| Phone Number: | 4802224600 |
| Fax Number: | 4802224619 |
| NPI Enumeration Date: | 07/18/2012 |
| NPI Last Update Date: | 08/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 005257 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |