Provider Demographics
NPI:1083873657
Name:TOTAL THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:TOTAL THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-724-6337
Mailing Address - Street 1:PO BOX 808
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485-0808
Mailing Address - Country:US
Mailing Address - Phone:931-231-5483
Mailing Address - Fax:
Practice Address - Street 1:308 HIGHWAY 64 E
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-3018
Practice Address - Country:US
Practice Address - Phone:931-231-5483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-08
Last Update Date:2008-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine