MEDICARE: SACRED ROOT THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1548127608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SACRED ROOT THERAPY

Provider Business Mailing Address
First Line	:	508 GREEN HARBOR CIR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37069-7190
Country	:	US
Telephone Number	:	615-419-5725
Fax Number	:

Provider Business Practice Location Address
First Line	:	508 GREEN HARBOR CIR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37069-7190
Country	:	US
Telephone Number	:	615-419-5725
Fax Number	:

Authorized Official
Title or Position	:	SOLE OWNER
Name	:	LAUREN RILEY DAMIANI
Credential	:	OTD
Telephone Number	:	615-419-5725

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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Directions to “SACRED ROOT THERAPY ” Practice Location

Language	Start Address	Practice Location

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