MADISON INTEGRATIVE MEDICINE ALLIANCE, INC; NPI #1366568412

Contact Information

MADISON INTEGRATIVE MEDICINE ALLIANCE, INC

6255 UNIVERSITY AVE
SUITE 202
MIDDLETON, WI 53562-3485

Phone: 608-238-3333
Fax: 608-238-3374
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Acupuncturist	171100000X

Indicates primary specialty

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NPI Profile & details for MADISON INTEGRATIVE MEDICINE ALLIANCE, INC

NPI Number 1366568412

LBN Legal business name MADISON INTEGRATIVE MEDICINE ALLIANCE, INC

Authorized official JONATHAN SONG - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/21/2007

Last updated 08/22/2020 - About 6 years ago

Identifiers

WI	License #	187
WI	License #	232

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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