Provider Demographics
NPI:1841616828
Name:TOTAL WELLNESS
Entity Type:Organization
Organization Name:TOTAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:P
Authorized Official - Last Name:OKEEFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-810-8677
Mailing Address - Street 1:5500 N WESTERN AVENUE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-4012
Mailing Address - Country:US
Mailing Address - Phone:405-810-8677
Mailing Address - Fax:405-810-8682
Practice Address - Street 1:5500 N WESTERN AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-4019
Practice Address - Country:US
Practice Address - Phone:405-810-8677
Practice Address - Fax:405-810-8682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty