Provider Demographics
NPI:1316208721
Name:TOTAL LIFE CLINIC
Entity Type:Organization
Organization Name:TOTAL LIFE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIZZINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:919-452-2012
Mailing Address - Street 1:1900 OLDE MILL FOREST DR.
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-8971
Mailing Address - Country:US
Mailing Address - Phone:919-452-2012
Mailing Address - Fax:919-803-7989
Practice Address - Street 1:1350 SE MAYNARD RD STE 201
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3634
Practice Address - Country:US
Practice Address - Phone:919-651-0820
Practice Address - Fax:919-651-0890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC365822083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Single Specialty