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General NPI Number Information
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NPI Number | 1578549978
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Entity Type | Organization
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Legal Business Name | TOTAL HEALTH HOLISTIC CENTER, INC.
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Dates
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Enumeration Date | 12/16/2005
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 24 HOLLAND RD APT 1
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City | WORCESTER
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State | MA
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Zip | 01603-1858
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Country | US
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Telephone | 978-821-7054
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Fax | 774-208-0712
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Provider Business Mailing Address
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Address Line | 24 HOLLAND RD APT 1
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City | WORCESTER
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State | MA
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Zip | 01603-1858
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Country | US
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Telephone | 978-821-7054
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Fax | 774-208-0712
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Authorized Official
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Title or Position | OWNER
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Name | KAREN LYNN ST.LAURENT
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Credential |
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Telephone | 978-821-7054
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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 | 2269
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License Number State | MA
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