Provider Demographics
NPI:1275832263
Name:INTEGRATED HEALTH CENTER, INC
Entity Type:Organization
Organization Name:INTEGRATED HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:MILANI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-302-3747
Mailing Address - Street 1:4910 MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-2732
Mailing Address - Country:US
Mailing Address - Phone:615-302-3747
Mailing Address - Fax:615-302-3030
Practice Address - Street 1:4910 MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2732
Practice Address - Country:US
Practice Address - Phone:615-302-3747
Practice Address - Fax:615-302-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC1312111N00000X
TN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty