Organization
MIDTN INTEGRATIVE THERAPEUTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT EDWARD FARRIS (OWNER)
(518) 817-3462
Entity
Organization
Contact information
Practice address
440 PARK AVE STE D, LEBANON, TN 37087-3665
(518) 817-3462
Mailing address
200 LOWELL CT, OLD HICKORY, TN 37138-1244
(518) 817-3462
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
04/11/2025
Last updated
04/11/2025
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