Healthcare Provider Details

I. General information

NPI: 1417470501
Provider Name (Legal Business Name): TRUE WELLNESS MEDICAL LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2017
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6102 SHALLOWFORD RD STE 103
CHATTANOOGA TN
37421-1684
US

IV. Provider business mailing address

6102 SHALLOWFORD RD STE 103
CHATTANOOGA TN
37421-1684
US

V. Phone/Fax

Practice location:
  • Phone: 423-475-6438
  • Fax:
Mailing address:
  • Phone: 423-475-6438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD0000055440
License Number StateTN

VIII. Authorized Official

Name: BRANDI VATT
Title or Position: DIRECTOR OF ADMINISTRATION
Credential:
Phone: 423-206-9947