Provider Demographics
NPI:1013491851
Name:TOTAL BODY DIAGNOSTICS
Entity Type:Organization
Organization Name:TOTAL BODY DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRL
Authorized Official - Middle Name:
Authorized Official - Last Name:STAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-893-2850
Mailing Address - Street 1:2 THE SQUARE AT LILLINGTON
Mailing Address - Street 2:
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-8030
Mailing Address - Country:US
Mailing Address - Phone:910-893-2850
Mailing Address - Fax:910-984-1515
Practice Address - Street 1:2 THE SQUARE AT LILLINGTON
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-8030
Practice Address - Country:US
Practice Address - Phone:910-893-2850
Practice Address - Fax:910-984-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty