Provider Demographics
NPI:1104069699
Name:TOTAL HEALTH CHIROPRACTIC
Entity type:Organization
Organization Name:TOTAL HEALTH CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GOULDBOURNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-805-3553
Mailing Address - Street 1:7760 ALHAMBRA BLVD
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5820
Mailing Address - Country:US
Mailing Address - Phone:954-961-2449
Mailing Address - Fax:954-961-2449
Practice Address - Street 1:16213 MIRAMAR PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4572
Practice Address - Country:US
Practice Address - Phone:954-805-3553
Practice Address - Fax:954-431-5074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9067111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty