Provider Demographics
NPI:1033457387
Name:TOTTY CHIROPRACTIC HEALTH & WELLNESS CENTER
Entity Type:Organization
Organization Name:TOTTY CHIROPRACTIC HEALTH & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:TOTTY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-883-1020
Mailing Address - Street 1:4733 ANDREW JACKSON PKWY
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1365
Mailing Address - Country:US
Mailing Address - Phone:615-883-1020
Mailing Address - Fax:615-883-3895
Practice Address - Street 1:4733 ANDREW JACKSON PKWY
Practice Address - Street 2:SUITE 1C
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1365
Practice Address - Country:US
Practice Address - Phone:615-883-1020
Practice Address - Fax:615-883-3895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN238111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T74482Medicare UPIN
TN103G705788Medicare PIN