Healthcare Provider Details

I. General information

NPI: 1649334137
Provider Name (Legal Business Name): TOTAL HEALTH CARE CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 02/07/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 S PENNSYLVANIA AVE STE 170
OKLAHOMA CITY OK
73159-6938
US

IV. Provider business mailing address

10001 S PENNSYLVANIA AVE STE 170
OKLAHOMA CITY OK
73159-6938
US

V. Phone/Fax

Practice location:
  • Phone: 405-834-4910
  • Fax: 405-681-2274
Mailing address:
  • Phone: 405-834-4910
  • Fax: 405-681-2274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC2616
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number3345
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number22740
License Number StateOK

VIII. Authorized Official

Name: DR. MICHAEL CHIAFFITELLI
Title or Position: OWNER,PRESIDENT
Credential: DC
Phone: 405-681-2273