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General NPI Number Information
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NPI Number | 1134292873
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Entity Type | Organization
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Legal Business Name | TOTAL WELLNESS CHIROPRACTIC CENTER OF BOWIE, LLC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 10/26/2009
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Provider Practice Location Address
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Address Line | 6000 LAUREL BOWIE RD SUITE 202
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City | BOWIE
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State | MD
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Zip | 20715-4000
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Country | US
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Telephone | 301-352-3454
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Fax | 301-352-0893
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Provider Business Mailing Address
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Address Line | 6000 LAUREL BOWIE RD SUITE 202
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City | BOWIE
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State | MD
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Zip | 20715-4000
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Country | US
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Telephone | 301-352-3454
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Fax | 301-352-0893
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Authorized Official
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Title or Position | ESTABLISHMENT EXECUTIVE
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Name | TINA MARIE KAPPES
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Credential |
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Telephone | 301-352-3454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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