Healthcare Provider Details

I. General information

NPI: 1457989113
Provider Name (Legal Business Name): TOTAL CARE MASSAGE AND ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 03/30/2020
Certification Date: 03/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1606 HANNAH ST
GREENEVILLE TN
37745-4359
US

IV. Provider business mailing address

1606 HANNAH ST
GREENEVILLE TN
37745-4359
US

V. Phone/Fax

Practice location:
  • Phone: 423-608-1641
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MORGAN JARNIGAN
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 423-839-1437