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General NPI Number Information
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NPI Number | 1851663199
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Entity Type | Organization
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Legal Business Name | CREATIVE HEALTH SOLUTIONS
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Dates
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Enumeration Date | 02/02/2012
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Last Update Date | 02/02/2012
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Provider Practice Location Address
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Address Line | 102 OVERLOOK DR
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City | WINTER HAVEN
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State | FL
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Zip | 33884-1600
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Country | US
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Telephone | 863-370-5142
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Fax |
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Provider Business Mailing Address
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Address Line | 102 OVERLOOK DR
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City | WINTER HAVEN
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State | FL
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Zip | 33884-1600
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Country | US
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Telephone | 863-370-5142
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. SHANNON SPRINKLE
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Credential |
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Telephone | 765-465-3203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | OTA7656
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License Number State | FL
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