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General NPI Number Information
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NPI Number | 1538333661
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Entity Type | Organization
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Legal Business Name | TOTAL PERFORMANCE, LLC
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 401 SOUTHWEST PLZ #103
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City | ARLINGTON
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State | TX
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Zip | 76016-4440
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Country | US
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Telephone | 817-561-4907
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Fax | 817-561-6740
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Provider Business Mailing Address
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Address Line | 401 SOUTHWEST PLZ #103
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City | ARLINGTON
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State | TX
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Zip | 76016-4440
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Country | US
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Telephone | 817-561-4907
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Fax | 817-561-6740
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Authorized Official
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Title or Position | DOCTOR/MANAGER
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Name | DR. MICHAEL SHAWN HOLDER
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Credential | D.C.
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Telephone | 469-544-4571
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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 | 9745
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License Number State | TX
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