=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053613273
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TOTAL APPROACH THERAPY, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/19/2010
-----------------------------------------------------
Last Update Date | 07/18/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 104 CHARLES ELDRIDGE DRIVE
-----------------------------------------------------
City | LAKEVILLE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-944-9907
-----------------------------------------------------
Fax | 508-947-0479
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 208 WAREHAM ST SUITE 213
-----------------------------------------------------
City | MIDDLEBORO
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02346-2828
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-944-9907
-----------------------------------------------------
Fax | 508-947-0479
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MARILYN ZURWASKI
-----------------------------------------------------
Credential | OTR/L
-----------------------------------------------------
Telephone | 508-944-9907
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | 1549
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------