MEDICARE: TOTAL THERAPY SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	2123	NM

General Provider Information

NPI Number	:	1346431400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL THERAPY SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	1300 COUNTRY CLUB RD STE C
Second Line	:
City	:	SANTA TERESA
State	:	NM
Zip	:	88008-9449
Country	:	US
Telephone Number	:	575-589-0303
Fax Number	:	575-589-4080

Provider Business Practice Location Address
First Line	:	1300 COUNTRY CLUB RD STE C
Second Line	:
City	:	SANTA TERESA
State	:	NM
Zip	:	88008-9449
Country	:	US
Telephone Number	:	575-589-0303
Fax Number	:	575-589-4080

Authorized Official
Title or Position	:	OWNER/PARTNER
Name	:	MS. CAROL MAUPIN MACIAS
Credential	:	OTR
Telephone Number	:	575-589-0303

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	10/15/2007

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