# TOTAL BODY CHIROPRACTIC CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174621841
- **Authorized official:** SHAD ALAN FOSTER D.C. (OWNER)
- **Authorized official phone:** (419) 238-6686

## Contact information

- **Practice address:** 415 E KIRACOFE AVE, ELIDA, OH 45807-1031
- **Practice address phone:** (419) 227-2639
- **Practice address fax:** (419) 227-2640
- **Mailing address:** 10963 VAN WERT DECATUR RD, VAN WERT, OH 45891-9211
- **Mailing address phone:** (419) 238-6686
- **Mailing address fax:** (419) 238-6201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 01/19/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2813781 | — | OH |