| Organization Name: | INTEGRATIVE MEDICAL ASSOCIATES, PLLC |
| NPI Number: | 1578783239 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CONNIE GENE ROSS (PRESIDENT) |
| Mailing Address: | 590 S Trade St Tryon |
| State: | NC US |
| Postal Code: | 287823714 |
| Phone Number: | 8288590420 |
| Fax Number: | 8288590422 |
| NPI Enumeration Date: | 04/26/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |