Provider Demographics
NPI:1043826910
Name:TOTAL WELLNESS MEDICAL CENTRE, LLC
Entity Type:Organization
Organization Name:TOTAL WELLNESS MEDICAL CENTRE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:JANKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-478-1443
Mailing Address - Street 1:495 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-9358
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1309 VEALE RD STE 12
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4609
Practice Address - Country:US
Practice Address - Phone:302-478-1443
Practice Address - Fax:302-478-1442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty