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General NPI Number Information
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NPI Number | 1346431400
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Entity Type | Organization
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Legal Business Name | TOTAL THERAPY SOLUTIONS LLC
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 1300 COUNTRY CLUB RD STE C
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City | SANTA TERESA
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State | NM
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Zip | 88008-9449
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Country | US
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Telephone | 575-589-0303
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Fax | 575-589-4080
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Provider Business Mailing Address
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Address Line | 1300 COUNTRY CLUB RD STE C
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City | SANTA TERESA
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State | NM
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Zip | 88008-9449
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Country | US
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Telephone | 575-589-0303
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Fax | 575-589-4080
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | MS. CAROL MAUPIN MACIAS
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Credential | OTR
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Telephone | 575-589-0303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2123
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License Number State | NM
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