Healthcare Provider Details

I. General information

NPI: 1922299338
Provider Name (Legal Business Name): TOTAL WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 02/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3191 MISSION INN AVE STE B
RIVERSIDE CA
92507-4188
US

IV. Provider business mailing address

3191B MISSION INN AVE
RIVERSIDE CA
92507-4138
US

V. Phone/Fax

Practice location:
  • Phone: 951-376-3380
  • Fax: 951-684-2980
Mailing address:
  • Phone: 951-684-2874
  • Fax: 951-684-2980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT12634
License Number StateCA

VIII. Authorized Official

Name: MICHAEL RAPPAPORT
Title or Position: CEO
Credential:
Phone: 951-684-2874