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General NPI Number Information
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NPI Number | 1548719362
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Entity Type | Organization
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Legal Business Name | TOTAL WELLNESS OF NORTH CAROLINA, INC
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Dates
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Enumeration Date | 09/22/2016
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Last Update Date | 09/22/2016
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Provider Practice Location Address
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Address Line | 1404 RAEFORD RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5028
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Country | US
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Telephone | 910-920-0468
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Fax |
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Provider Business Mailing Address
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Address Line | 1404 RAEFORD RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5028
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Country | US
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Telephone | 910-920-0468
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MISTY RHIANNON HUTTON
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Credential | DC, MAOM, LAC
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Telephone | 949-566-4056
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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 | 4551
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 829
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License Number State | NC
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