Provider Demographics
NPI:1841351889
Name:TOTAL TOUCH CHIROPRACTIC WELLNESS CENTER,PA
Entity type:Organization
Organization Name:TOTAL TOUCH CHIROPRACTIC WELLNESS CENTER,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:D
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-697-9818
Mailing Address - Street 1:PO BOX 19982
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-0982
Mailing Address - Country:US
Mailing Address - Phone:704-697-9818
Mailing Address - Fax:704-697-9812
Practice Address - Street 1:3000 BEATTIES FORD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-3732
Practice Address - Country:US
Practice Address - Phone:704-697-9818
Practice Address - Fax:704-697-9812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2491111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8901108Medicaid
NC890833MMedicaid
NC0833MOtherNC STATE PLAN
NC2452964Medicare ID - Type Unspecified