Organization
NTANDEM FITNESS AND NUTRITION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS TODD HOUSE MD (MEMBER)
(502) 693-2037
Entity
Organization
Contact information
Practice address
239 HOOHANA ST, KAHULUI, HI 96732-2452
(502) 693-2037
(502) 795-3507
Mailing address
1064 EVERETT AVE APT 6, LOUISVILLE, KY 40204-1272
(502) 693-2037
(502) 795-3507
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
17081
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
421264647
FEIN
—
Enumeration date
04/11/2015
Last updated
06/17/2015
Update your record
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