Provider Demographics
NPI:1871972471
Name:INTEGRATIVE HEALTHCARE SOLUTIONS LLC
Entity type:Organization
Organization Name:INTEGRATIVE HEALTHCARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEDDA
Authorized Official - Suffix:
Authorized Official - Credentials:ACNP
Authorized Official - Phone:864-938-4888
Mailing Address - Street 1:302 JACOBS HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325-9415
Mailing Address - Country:US
Mailing Address - Phone:864-938-4888
Mailing Address - Fax:
Practice Address - Street 1:302 JACOBS HWY
Practice Address - Street 2:SUITE A
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-9415
Practice Address - Country:US
Practice Address - Phone:864-938-4888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPRN3839363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty