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General NPI Number Information
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NPI Number | 1326302472
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Entity Type | Organization
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Legal Business Name | TOTAL ORTHOPEDICS,LLC
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Dates
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Enumeration Date | 07/03/2012
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 18001 N 79TH AVE SUITE D-69
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City | GLENDALE
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State | AZ
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Zip | 85308-8388
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Country | US
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Telephone | 483-443-0384
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Fax |
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Provider Business Mailing Address
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Address Line | 18001 N 79TH AVE SUITE D-69
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City | GLENDALE
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State | AZ
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Zip | 85308-8388
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS OPERATIONS DIRECTOR
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Name | AMANDA WILKINSON
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Credential |
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Telephone | 702-818-0446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 44D1072470
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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