Provider Demographics
NPI:1346543998
Name:TOTAL HEALTH CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:TOTAL HEALTH CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ANNIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-621-2541
Mailing Address - Street 1:460 2ND ST STE B
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-6300
Mailing Address - Country:US
Mailing Address - Phone:801-621-2541
Mailing Address - Fax:
Practice Address - Street 1:460 2ND ST STE B
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-6300
Practice Address - Country:US
Practice Address - Phone:801-621-2541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2857221202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000056106Medicare PIN