Healthcare Provider Details

I. General information

NPI: 1770829335
Provider Name (Legal Business Name): TOTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2012
Last Update Date: 12/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 LAKE CAROLINA WAY STE 110
COLUMBIA SC
29229-7562
US

IV. Provider business mailing address

5 LAKE CAROLINA WAY STE 110
COLUMBIA SC
29229-7562
US

V. Phone/Fax

Practice location:
  • Phone: 803-865-7720
  • Fax:
Mailing address:
  • Phone: 803-865-7720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2146
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ONEYKE NAPU DAVIS
Title or Position: OWNER
Credential: DC
Phone: 803-865-7720