Organization
TOTAL HEALTH CORPORATION
Active
Other names
Total Health Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY ALAN FULLING MS,PT (OWNER)
(360) 432-2193
Entity
Organization
Contact information
Practice address
2142 W RAILROAD AVE, SUITE A, SHELTON, WA 98584-7813
(360) 426-0175
(360) 432-2193
Mailing address
2142 W RAILROAD AVE, SUITE A, SHELTON, WA 98584-7813
(360) 426-0175
(360) 432-2193
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT00007816
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125536
LABOR AND INDUSTRIES
WA
05
—
7095037
—
WA
05
—
8347130
—
WA
Enumeration date
12/19/2006
Last updated
02/02/2015
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