Provider Demographics
NPI:1154857787
Name:TOTALCARE
Entity Type:Organization
Organization Name:TOTALCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:REGINATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-822-5644
Mailing Address - Street 1:1700 N STATE ST STE 16
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-1008
Mailing Address - Country:US
Mailing Address - Phone:801-822-5644
Mailing Address - Fax:
Practice Address - Street 1:1700 N STATE ST STE 16
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-1008
Practice Address - Country:US
Practice Address - Phone:801-822-5644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty