Organization
ADVANCED INTEGRATIVE MEDICINE
Active
Other names
AIM
Organization subpart
No
Provider details
NPI number
Authorized official
DERRYL NOWAK (COO)
(401) 206-0715
Entity
Organization
Contact information
Practice address
320 PHILLIPS ST FL 1, NORTH KINGSTOWN, RI 02852-5166
(401) 206-0715
Mailing address
8204 LISA LN, SMYRNA, TN 37167-3364
(401) 206-0715
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
171000000X
Military Health Care Provider
—
—
207Q00000X
Family Medicine Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
225700000X
Massage Therapist
—
—
261QP3300X
Pain Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
261QV0200X
VA Clinic/Center
—
—
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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