Provider Demographics
NPI:1003457540
Name:INTEGRATIVE NUTRITION & HEALING LLC
Entity Type:Organization
Organization Name:INTEGRATIVE NUTRITION & HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:PREETI
Authorized Official - Middle Name:
Authorized Official - Last Name:BANSAL KSHIRSAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MPH RD LD
Authorized Official - Phone:513-506-2868
Mailing Address - Street 1:3536 EDWARDS RD STE 210
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-1358
Mailing Address - Country:US
Mailing Address - Phone:513-506-2868
Mailing Address - Fax:513-986-5047
Practice Address - Street 1:3536 EDWARDS RD STE 210
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208
Practice Address - Country:US
Practice Address - Phone:513-506-2868
Practice Address - Fax:513-986-5047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-07
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service