Healthcare Provider Details

I. General information

NPI: 1396141081
Provider Name (Legal Business Name): TOTAL HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2014
Last Update Date: 03/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1036 E BENDER BLVD
HOBBS NM
88240-2416
US

IV. Provider business mailing address

3108 DESTINY POINT DR
EL PASO TX
79938-5464
US

V. Phone/Fax

Practice location:
  • Phone: 575-318-2233
  • Fax:
Mailing address:
  • Phone: 915-778-7778
  • Fax: 915-591-0421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1594
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD2014-0849
License Number StateNM

VIII. Authorized Official

Name: DR. LUIS R MARIONI
Title or Position: PROVIDER/OWNER
Credential: DC
Phone: 575-318-2233