Provider Demographics
NPI:1750508123
Name:TOTAL WELLNESS CHIROPRACTIC CLINIC, P.C.
Entity Type:Organization
Organization Name:TOTAL WELLNESS CHIROPRACTIC CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VOLLMERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-224-9500
Mailing Address - Street 1:1025 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-3555
Mailing Address - Country:US
Mailing Address - Phone:701-224-9500
Mailing Address - Fax:701-224-9511
Practice Address - Street 1:1025 N 3RD ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3555
Practice Address - Country:US
Practice Address - Phone:701-224-9500
Practice Address - Fax:701-224-9511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND13745Medicaid
ND711918Medicare ID - Type Unspecified