Provider Demographics
NPI:1104636299
Name:TOTAL BODY LLC
Entity type:Organization
Organization Name:TOTAL BODY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:TROSDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:218-282-0455
Mailing Address - Street 1:110 W HENNING ST APT 121
Mailing Address - Street 2:
Mailing Address - City:BATTLE LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56515-2904
Mailing Address - Country:US
Mailing Address - Phone:218-282-0455
Mailing Address - Fax:
Practice Address - Street 1:110 W HENNING ST APT 121
Practice Address - Street 2:
Practice Address - City:BATTLE LAKE
Practice Address - State:MN
Practice Address - Zip Code:56515-2904
Practice Address - Country:US
Practice Address - Phone:218-282-0455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty