Provider Demographics
NPI:1174702286
Name:TOTAL HEALTH WELLNESS CENTER, P.C.
Entity type:Organization
Organization Name:TOTAL HEALTH WELLNESS CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-523-9192
Mailing Address - Street 1:10267 S 1300 E
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-4078
Mailing Address - Country:US
Mailing Address - Phone:801-523-9192
Mailing Address - Fax:801-523-9490
Practice Address - Street 1:10267 S 1300 E
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-4078
Practice Address - Country:US
Practice Address - Phone:801-523-9192
Practice Address - Fax:801-523-9490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3632311202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty