Provider Demographics
NPI:1831323450
Name:TOTAL WELLNESS CENTER
Entity Type:Organization
Organization Name:TOTAL WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:S
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:803-413-1551
Mailing Address - Street 1:121 CHINQUAPIN CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-2902
Mailing Address - Country:US
Mailing Address - Phone:803-413-1551
Mailing Address - Fax:
Practice Address - Street 1:1410 BLANDING ST
Practice Address - Street 2:SUITE 203
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2967
Practice Address - Country:US
Practice Address - Phone:803-413-1551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty