Provider Demographics
NPI:1831585058
Name:INNOVATIV HEALTH, LLC
Entity type:Organization
Organization Name:INNOVATIV HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:SHANE
Authorized Official - Last Name:DREHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:828-638-9990
Mailing Address - Street 1:1739 MAYBANK HWY
Mailing Address - Street 2:UNIT D
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-2103
Mailing Address - Country:US
Mailing Address - Phone:843-640-3224
Mailing Address - Fax:
Practice Address - Street 1:1739 MAYBANK HWY
Practice Address - Street 2:UNIT D
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2103
Practice Address - Country:US
Practice Address - Phone:843-640-3224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3725111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty