Provider Demographics
NPI:1154069201
Name:TOTAL BODY WELLNESS
Entity Type:Organization
Organization Name:TOTAL BODY WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:VANDERKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:269-762-1521
Mailing Address - Street 1:931 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-4401
Mailing Address - Country:US
Mailing Address - Phone:269-762-1521
Mailing Address - Fax:
Practice Address - Street 1:103 W PRAIRIE ST
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MI
Practice Address - Zip Code:49097-1258
Practice Address - Country:US
Practice Address - Phone:269-529-7554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty