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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adult Medicine |
207QA0505X | 08 | Physician/Family Practice |
| NPI # | 1922408608 |
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| LBN Legal business name | SAGE INTEGRATIVE MEDICINE PLLC | ||||
| Authorized official | MARNEY ROEMMELT - (OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 08/29/2014 | ||||
| Last updated | 08/29/2014 - About 12 years ago | ||||
| Identifiers |
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SAGE INTEGRATIVE MEDICINE PLLC