Healthcare Provider Details

I. General information

NPI: 1003457540
Provider Name (Legal Business Name): INTEGRATIVE NUTRITION & HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 11/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3536 EDWARDS RD STE 210
CINCINNATI OH
45208
US

IV. Provider business mailing address

3536 EDWARDS RD STE 210
CINCINNATI OH
45208-1358
US

V. Phone/Fax

Practice location:
  • Phone: 513-506-2868
  • Fax: 513-986-5047
Mailing address:
  • Phone: 513-506-2868
  • Fax: 513-986-5047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PREETI BANSAL KSHIRSAGAR
Title or Position: FOUNDER DIETITIAN
Credential: MPH RD LD
Phone: 513-506-2868