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General NPI Number Information
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NPI Number | 1972863868
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Entity Type | Organization
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Legal Business Name | INNOVATIVE HEALTH SOLUTIONS LLC
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Dates
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Enumeration Date | 05/24/2012
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 701 SPRING LAKE RD
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-6450
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Country | US
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Telephone | 321-948-1335
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Fax |
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Provider Business Mailing Address
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Address Line | 701 SPRING LAKE RD
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-6450
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Country | US
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Telephone | 321-948-1335
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONALD L FULMORE II
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Credential | D.C.
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Telephone | 321-948-1335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH10202
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | FL
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