Provider Demographics
NPI:1316320120
Name:INTEGRATED HEALTH AND INJURY CENTER
Entity type:Organization
Organization Name:INTEGRATED HEALTH AND INJURY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-229-6222
Mailing Address - Street 1:4150 SNAPFINGER WOODS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-3417
Mailing Address - Country:US
Mailing Address - Phone:404-288-9000
Mailing Address - Fax:678-705-8429
Practice Address - Street 1:4150 SNAPFINGER WOODS DR STE 200
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-3417
Practice Address - Country:US
Practice Address - Phone:404-288-9000
Practice Address - Fax:678-705-8429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA040613261QP2300X
GA111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty