Healthcare Provider Details

I. General information

NPI: 1992496293
Provider Name (Legal Business Name): TOTALCARE THERAPEUTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 MARGO RD SW
ALBUQUERQUE NM
87105-6811
US

IV. Provider business mailing address

2222 MARGO RD SW
ALBUQUERQUE NM
87105-6811
US

V. Phone/Fax

Practice location:
  • Phone: 541-604-6086
  • Fax:
Mailing address:
  • Phone: 541-604-6086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHRISTOPHER ANTHONY GROSSMAN
Title or Position: OWNER
Credential: MS, PT, C-DN
Phone: 541-604-6086