Healthcare Provider Details
I. General information
NPI: 1245853167
Provider Name (Legal Business Name): INTEGRATIVE HEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2020
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
505 W PALMETTO ST
FLORENCE SC
29501-4427
US
IV. Provider business mailing address
505 W PALMETTO ST
FLORENCE SC
29501-4427
US
V. Phone/Fax
- Phone: 843-799-0001
- Fax: 843-799-0029
- Phone: 843-799-0001
- Fax: 843-799-0029
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KRISTIN
HIESHETTER
Title or Position: CO-OWNER
Credential: DC
Phone: 414-758-1784