Healthcare Provider Details

I. General information

NPI: 1063922805
Provider Name (Legal Business Name): HALLOWITZ HOLISTIC HEALING, P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 05/15/2020
Certification Date: 05/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 E SHERMAN AVE
COEUR D ALENE ID
83814-4149
US

IV. Provider business mailing address

PO BOX 3482
POST FALLS ID
83877-3482
US

V. Phone/Fax

Practice location:
  • Phone: 208-665-2293
  • Fax: 208-664-8973
Mailing address:
  • Phone: 208-209-6170
  • Fax: 208-209-6169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU-283
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. TOBY KYLE HALLOWITZ
Title or Position: PRESIDENT
Credential: ND, MSOM, EAMP
Phone: 509-869-4206