| Organization Name: | TOTAL HEALTH MEDICAL CLINIC, LLC |
| NPI Number: | 1124496575 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CANDACE HARRIS (FNP/CO-OWNER) |
| Mailing Address: | 1204 W Poplar Ave Suite 102 Collierville |
| State: | TN US |
| Postal Code: | 380173103 |
| Phone Number: | 9016103135 |
| Fax Number: | |
| NPI Enumeration Date: | 09/02/2015 |
| NPI Last Update Date: | 02/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 18449 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |