Healthcare Provider Details

I. General information

NPI: 1952533713
Provider Name (Legal Business Name): TOTAL HEALTH AND WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2009
Last Update Date: 08/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 NEW COVINGTON PIKE STE 109
MEMPHIS TN
38128-2526
US

IV. Provider business mailing address

3900 NEW COVINGTON PIKE STE 109
MEMPHIS TN
38128-2526
US

V. Phone/Fax

Practice location:
  • Phone: 901-373-4001
  • Fax: 800-594-8026
Mailing address:
  • Phone: 901-373-4001
  • Fax: 800-594-8026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberAPN0000008020
License Number StateTN

VIII. Authorized Official

Name: MRS. ORA L ROBINSON
Title or Position: CEO
Credential:
Phone: 901-301-8974