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General NPI Number Information
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NPI Number | 1295913143
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Entity Type | Organization
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Legal Business Name | INTEGRATED THERAPIES INC
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Dates
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Enumeration Date | 02/02/2008
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 1450 N US HIGHWAY 1 SUITE 900
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City | ORMOND BEACH
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State | FL
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Zip | 32174-6622
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Country | US
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Telephone | 386-671-2112
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Fax | 386-671-2113
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Provider Business Mailing Address
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Address Line | 454 LEEWAY TRL
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City | ORMOND BEACH
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State | FL
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Zip | 32174-2563
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Country | US
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Telephone | 386-451-2781
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Fax | 386-671-2113
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KELLY ELIZABETH VAN RIJ
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Credential | RPT, L.AC.
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Telephone | 386-451-2781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP 1788
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 8620
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License Number State | FL
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