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Organization
TOTALCARE WELLNESS AND PHYSICAL THERAPY LLC
Active
Organization
TOTALCARE WELLNESS AND PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BAYO UWAIFO SEDENU PT, PHD (CEO)
(678) 894-5628
Entity
Organization
Contact information
Practice address
1301 LOW WATER WAY, LAWRENCEVILLE, GA 30045-7079
(678) 894-5628
Mailing address
1301 LOW WATER WAY, LAWRENCEVILLE, GA 30045-7079
(678) 894-5628
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT011267
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14025628
CERTIFICATE OF ORGANIZATION
GA
Enumeration date
08/01/2014
Last updated
08/01/2014
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