Provider Demographics
NPI:1023755808
Name:TOTAL HEALTH CHIROPRACTIC LLC
Entity type:Organization
Organization Name:TOTAL HEALTH CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-294-4944
Mailing Address - Street 1:1637 BOULDER CITY PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-1930
Mailing Address - Country:US
Mailing Address - Phone:702-294-4944
Mailing Address - Fax:
Practice Address - Street 1:1637 BOULDER CITY PKWY STE B
Practice Address - Street 2:
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-1930
Practice Address - Country:US
Practice Address - Phone:702-294-4944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty