Basic Information
| Provider Information | |||||||||
| NPI: | 1275832263 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INTEGRATED HEALTH CENTER, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4910 MAIN ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SPRING HILL | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371742732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153023747 | ||||||||
| FaxNumber: | 6153023030 | ||||||||
| Practice Location | |||||||||
| Address1: | 4910 MAIN ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SPRING HILL | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371742732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153023747 | ||||||||
| FaxNumber: | 6153023030 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2011 | ||||||||
| LastUpdateDate: | 03/16/2011 | ||||||||
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| AuthorizedOfficialLastName: | MILANI | ||||||||
| AuthorizedOfficialFirstName: | MARIO | ||||||||
| AuthorizedOfficialMiddleName: | MARTIN | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6153023747 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.C. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | DC1312 | TN | N | 193200000X MULTI-SPECIALTY GROUP | Chiropractic Providers | Chiropractor | 164W00000X | TN | Y | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.