Healthcare Provider Details

I. General information

NPI: 1457964355
Provider Name (Legal Business Name): INTEGRATED RX OUTCOMES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 08/28/2020
Certification Date: 08/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

447 LAKE VICTORIA CIR
MELBOURNE FL
32940-1873
US

IV. Provider business mailing address

447 LAKE VICTORIA CIR
MELBOURNE FL
32940-1873
US

V. Phone/Fax

Practice location:
  • Phone: 734-904-2529
  • Fax:
Mailing address:
  • Phone: 734-904-2529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISITA ACKERMANN
Title or Position: OWNER
Credential: PHD
Phone: 734-904-2529