| Total Wellness Center Llc | |
|
300 W Dixie Ave Ste 200 Elizabethtown KY 42701-1764 | |
| (270) 982-0855 | |
| (270) 982-0866 |
| Full Name | Total Wellness Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 W Dixie Ave Ste 200, Elizabethtown, Kentucky |
| Authorized Official Name and Position | Sarah Ann Manning (OWNER) |
| Authorized Official Contact | 5026161905 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Wellness Center Llc 300 W Dixie Ave Ste 200 Elizabethtown KY 42701-1764 Ph: (270) 982-0855 | Total Wellness Center Llc 300 W Dixie Ave Ste 200 Elizabethtown KY 42701-1764 Ph: (270) 982-0855 |
| NPI Number | 1306609128 |
|---|---|
| Provider Enumeration Date | 02/05/2024 |
| Last Update Date | 01/13/2025 |
| Certification Date | 01/13/2025 |
| Medicare PECOS PAC ID | 6002343886 |
|---|---|
| Medicare Enrollment ID | O20241217004260 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306609128 | NPI | - | NPPES |
| 7100967850 | Medicaid | KY |
| Provider Name | Sarah Tyler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053039123 PECOS PAC ID: 3274919915 Enrollment ID: I20241217004373 |
| Provider Name | Trevor Craig Mcguffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154001030 PECOS PAC ID: 8426585506 Enrollment ID: I20241231003529 |
| Provider Name | Andrew Dane Russell Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972283844 PECOS PAC ID: 2860929957 Enrollment ID: I20241231003660 |
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