OrganizationActive
21st Century Total Wellness, LLC
NPI 1043412711 · Specialist · Demotte, IN
Provider details
- NPI number
- 1043412711
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Authorized official
- Edgar Prater, Resident Agent
Mailing address
5522 E 989 N
Demotte, IN 46310-8016
Registry dates
- Enumerated
- 2007-06-04
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.