Provider Demographics
NPI:1629323134
Name:TOTAL WELLNESS CENTER OF ACADIANA
Entity Type:Organization
Organization Name:TOTAL WELLNESS CENTER OF ACADIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATH
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUDOLPH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:337-267-4262
Mailing Address - Street 1:106 OIL CENTER DRIVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503
Mailing Address - Country:US
Mailing Address - Phone:337-267-4262
Mailing Address - Fax:
Practice Address - Street 1:220 RIVER ROAD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501
Practice Address - Country:US
Practice Address - Phone:337-267-4262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty