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General NPI Number Information
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NPI Number | 1467891176
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE HEALTH INSTITUTE LLC
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 6100 GLADES RD SUITE 310
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City | BOCA RATON
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State | FL
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Zip | 33434-4325
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Country | US
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Telephone | 561-756-9405
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Fax | 561-206-0967
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Provider Business Mailing Address
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Address Line | 6100 GLADES RD SUITE 310
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City | BOCA RATON
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State | FL
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Zip | 33434-4325
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Country | US
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Telephone | 561-756-9405
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Fax | 561-206-0967
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. LAURA ELIZABETH SKELLCHOCK
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Credential | MD
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Telephone | 561-756-9405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 88323
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License Number State | FL
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