Provider Demographics
NPI:1154648616
Name:TOTAL HEALTH & INJURY CENTER LLC
Entity Type:Organization
Organization Name:TOTAL HEALTH & INJURY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-729-0502
Mailing Address - Street 1:5700 LAKE WORTH RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-4727
Mailing Address - Country:US
Mailing Address - Phone:561-729-0502
Mailing Address - Fax:561-729-0589
Practice Address - Street 1:5700 LAKE WORTH RD
Practice Address - Street 2:SUITE 111
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-4727
Practice Address - Country:US
Practice Address - Phone:561-729-0502
Practice Address - Fax:561-729-0589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service