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General NPI Number Information
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NPI Number | 1477048320
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE HEALTH AND SPORTS MEDICINE
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Dates
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Enumeration Date | 06/23/2018
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 4010 EXECUTIVE PARK DR STE 135
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City | CINCINNATI
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State | OH
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Zip | 45241-4013
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Country | US
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Telephone | 513-742-2669
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 18337
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City | CINCINNATI
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State | OH
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Zip | 45218-0337
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Country | US
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Telephone | 513-742-2669
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Fax | 513-488-0523
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Authorized Official
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Title or Position | DIRECTOR
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Name | JAMEEL MIKAL MOKSA BATTLE
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Credential | PT, AT, DIPL. OM
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Telephone | 513-349-4665
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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