Provider Demographics
NPI:1619359668
Name:INTEGRATED HEALTHCARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:INTEGRATED HEALTHCARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTORQQ
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-772-9065
Mailing Address - Street 1:10198 SPRINGFIELD PIKE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-1448
Mailing Address - Country:US
Mailing Address - Phone:513-772-9065
Mailing Address - Fax:513-772-2961
Practice Address - Street 1:10198 SPRINGFIELD PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-1448
Practice Address - Country:US
Practice Address - Phone:513-772-9065
Practice Address - Fax:513-772-2961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-26
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4212111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0107558Medicaid
OH1699054437Medicare PIN