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General NPI Number Information
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NPI Number | 1508181728
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Entity Type | Organization
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Legal Business Name | TOTAL BODY HEALTH CENTER SC
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Dates
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Enumeration Date | 03/31/2010
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Last Update Date | 11/12/2010
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Provider Practice Location Address
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Address Line | 1121 E MAIN ST SUITE 140
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City | ST CHARLES
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State | IL
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Zip | 60174-2205
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Country | US
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Telephone | 630-587-5824
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Fax | 630-587-5834
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Provider Business Mailing Address
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Address Line | 1121 E MAIN ST SUITE 140
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City | ST CHARLES
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State | IL
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Zip | 60174-2205
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Country | US
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Telephone | 630-587-5824
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Fax | 630-587-5834
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Authorized Official
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Title or Position | PRESIDENT/CHIROPRACTIC PHYSICIAN
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Name | DR. ARUN GANAPATHY MANI
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Credential | D.C.
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Telephone | 630-587-5824
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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 | 038-009381
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License Number State | IL
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