Healthcare Provider Details

I. General information

NPI: 1114479235
Provider Name (Legal Business Name): TENNESSEE INTEGRATED MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11562 CHAPMAN HWY
SEYMOUR TN
37865-5044
US

IV. Provider business mailing address

11562 CHAPMAN HWY
SEYMOUR TN
37865-5044
US

V. Phone/Fax

Practice location:
  • Phone: 865-609-3330
  • Fax: 865-609-3390
Mailing address:
  • Phone: 865-609-3330
  • Fax: 865-609-3390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number20929
License Number StateTN

VIII. Authorized Official

Name: DR. DANIEL STEVEN GIAMMO
Title or Position: OWNER
Credential: DC
Phone: 865-609-3330