Provider Demographics
NPI:1215588090
Name:TOTAL HEALTH PHYSICAL MEDICINE AND REHAB CENTER
Entity Type:Organization
Organization Name:TOTAL HEALTH PHYSICAL MEDICINE AND REHAB CENTER
Other - Org Name:PREMIER SCULPTING CENTER OF NJ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-377-6327
Mailing Address - Street 1:137 MAIN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045-9231
Mailing Address - Country:US
Mailing Address - Phone:973-947-6700
Mailing Address - Fax:
Practice Address - Street 1:137 MAIN RD STE 100
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-9231
Practice Address - Country:US
Practice Address - Phone:973-947-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOTAL HEALTH PHYSICAL MEDICINE & REHABILITATION CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-24
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty