Provider Demographics
NPI:1346431400
Name:TOTAL THERAPY SOLUTIONS LLC
Entity Type:Organization
Organization Name:TOTAL THERAPY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:MAUPIN
Authorized Official - Last Name:MACIAS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:575-589-0303
Mailing Address - Street 1:1300 COUNTRY CLUB RD STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA TERESA
Mailing Address - State:NM
Mailing Address - Zip Code:88008-9449
Mailing Address - Country:US
Mailing Address - Phone:575-589-0303
Mailing Address - Fax:575-589-4080
Practice Address - Street 1:1300 COUNTRY CLUB RD STE C
Practice Address - Street 2:
Practice Address - City:SANTA TERESA
Practice Address - State:NM
Practice Address - Zip Code:88008-9449
Practice Address - Country:US
Practice Address - Phone:575-589-0303
Practice Address - Fax:575-589-4080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2123261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center