Provider Demographics
NPI:1154791481
Name:PREVENTIVE HEALTH INITIATIVE
Entity type:Organization
Organization Name:PREVENTIVE HEALTH INITIATIVE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC, RN
Authorized Official - Phone:615-200-7122
Mailing Address - Street 1:2933 BERRY HILL DR STE A
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3126
Mailing Address - Country:US
Mailing Address - Phone:615-200-7122
Mailing Address - Fax:
Practice Address - Street 1:2933 BERRY HILL DR STE A
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3126
Practice Address - Country:US
Practice Address - Phone:615-200-7122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2273111N00000X
TN191977163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty