MEDICARE: INTEGRATIVE HEALTHCARE SOLUTIONS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1427383215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATIVE HEALTHCARE SOLUTIONS, INC

Provider Business Mailing Address
First Line	:	1313 BEACH BLVD
Second Line	:	SUITE C
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3429
Country	:	US
Telephone Number	:	904-372-0623
Fax Number	:	904-372-0675

Provider Business Practice Location Address
First Line	:	1313 BEACH BLVD
Second Line	:	SUITE C
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3429
Country	:	US
Telephone Number	:	904-372-0623
Fax Number	:	904-372-0675

Authorized Official
Title or Position	:	CHIROPRACTIC PHYSICIAN
Name	:	DR. EDGAR VESCE
Credential	:	D.C.
Telephone Number	:	904-372-0623

Provider Enumeration Date	:	10/12/2009
Last Update Date	:	02/17/2020

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