Provider Demographics
NPI:1609121664
Name:TOTAL FITNESS WELLNESS MS P
Entity Type:Organization
Organization Name:TOTAL FITNESS WELLNESS MS P
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WELLNESS AND FITNESS COACH
Authorized Official - Prefix:MISS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:F
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-572-1782
Mailing Address - Street 1:109 HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-3901
Mailing Address - Country:US
Mailing Address - Phone:770-572-1782
Mailing Address - Fax:
Practice Address - Street 1:109 HAMPTON DR
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-3901
Practice Address - Country:US
Practice Address - Phone:770-572-1782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health