Provider Demographics
NPI:1144490376
Name:TOTAL FAMILY WELLNESS INC.
Entity type:Organization
Organization Name:TOTAL FAMILY WELLNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-856-3545
Mailing Address - Street 1:105 SE GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAREDGE
Mailing Address - State:CO
Mailing Address - Zip Code:81413-4003
Mailing Address - Country:US
Mailing Address - Phone:970-856-3545
Mailing Address - Fax:970-856-3545
Practice Address - Street 1:105 SE GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:CEDAREDGE
Practice Address - State:CO
Practice Address - Zip Code:81413-4003
Practice Address - Country:US
Practice Address - Phone:970-856-3545
Practice Address - Fax:970-856-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5432111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
489848Medicare UPIN