Provider Demographics
NPI:1114479235
Name:TENNESSEE INTEGRATED MEDICINE
Entity Type:Organization
Organization Name:TENNESSEE INTEGRATED MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:GIAMMO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:865-609-3330
Mailing Address - Street 1:11562 CHAPMAN HWY
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-5044
Mailing Address - Country:US
Mailing Address - Phone:865-609-3330
Mailing Address - Fax:865-609-3390
Practice Address - Street 1:11562 CHAPMAN HWY
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865-5044
Practice Address - Country:US
Practice Address - Phone:865-609-3330
Practice Address - Fax:865-609-3390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20929363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty