Provider Demographics
NPI:1982779179
Name:TOTAL HEALTH NETWORK
Entity Type:Organization
Organization Name:TOTAL HEALTH NETWORK
Other - Org Name:BODY MIND & SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:TRUMPS
Authorized Official - Suffix:
Authorized Official - Credentials:DC OT
Authorized Official - Phone:504-915-9155
Mailing Address - Street 1:2626 N ARNOULT RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-5949
Mailing Address - Country:US
Mailing Address - Phone:504-915-9155
Mailing Address - Fax:504-324-0384
Practice Address - Street 1:2626 N ARNOULT RD
Practice Address - Street 2:SUITE 220
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-5949
Practice Address - Country:US
Practice Address - Phone:504-915-9155
Practice Address - Fax:504-324-0384
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOTAL HEALTH NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-22
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1269111N00000X
LA210347225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
R15128Medicare UPIN
LA4C045CF30Medicare ID - Type Unspecified