Provider Demographics
NPI:1710158985
Name:TOTAL WELLNESS LLC
Entity Type:Organization
Organization Name:TOTAL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:W
Authorized Official - Last Name:DURANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-437-9083
Mailing Address - Street 1:133 E 1ST NORTH ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-6873
Mailing Address - Country:US
Mailing Address - Phone:843-437-9083
Mailing Address - Fax:
Practice Address - Street 1:133 E 1ST NORTH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6873
Practice Address - Country:US
Practice Address - Phone:843-437-9083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty