Provider Demographics
NPI:1194228213
Name:TOTAL BODY WELLNESS PRO
Entity Type:Organization
Organization Name:TOTAL BODY WELLNESS PRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSO
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:678-821-2810
Mailing Address - Street 1:2121 FOUNTAIN DR STE I
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2900
Mailing Address - Country:US
Mailing Address - Phone:678-821-2810
Mailing Address - Fax:678-894-0342
Practice Address - Street 1:2121 FOUNTAIN DR STE I
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2900
Practice Address - Country:US
Practice Address - Phone:678-821-2810
Practice Address - Fax:678-894-0342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2021-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty