Healthcare Provider Details

I. General information

NPI: 1770880791
Provider Name (Legal Business Name): INTEGRATED HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2011
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 S KING ST SUITE 1564
HONOLULU HI
96814-1956
US

IV. Provider business mailing address

1314 S KING ST SUITE 1564
HONOLULU HI
96814-1956
US

V. Phone/Fax

Practice location:
  • Phone: 808-888-9971
  • Fax:
Mailing address:
  • Phone: 808-888-9971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number6086
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. DAMIAN SMITH
Title or Position: OWNER
Credential: DC
Phone: 808-888-9971