Provider Demographics
NPI:1952076077
Name:TOTAL HEALTH CENTER KENNETT SQUARE LLC
Entity Type:Organization
Organization Name:TOTAL HEALTH CENTER KENNETT SQUARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-444-8155
Mailing Address - Street 1:226 STATE STREET
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348
Mailing Address - Country:US
Mailing Address - Phone:610-608-9931
Mailing Address - Fax:
Practice Address - Street 1:226 EAST STATE STREET
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-3125
Practice Address - Country:US
Practice Address - Phone:610-444-8155
Practice Address - Fax:610-444-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-11
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty