Provider Demographics
NPI:1417553025
Name:INTEGRITY WELLNESS, INC
Entity Type:Organization
Organization Name:INTEGRITY WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:LANE
Authorized Official - Last Name:RAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LADAC II
Authorized Official - Phone:615-417-3972
Mailing Address - Street 1:719 MONARCHOS BND
Mailing Address - Street 2:
Mailing Address - City:BURNS
Mailing Address - State:TN
Mailing Address - Zip Code:37029-2001
Mailing Address - Country:US
Mailing Address - Phone:615-417-3972
Mailing Address - Fax:
Practice Address - Street 1:100 S MULBERRY ST
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1941
Practice Address - Country:US
Practice Address - Phone:615-417-3972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)