Provider Demographics
NPI:1174630982
Name:TOTAL REHAB, INC
Entity Type:Organization
Organization Name:TOTAL REHAB, INC
Other - Org Name:FREDERICKSBURG TOTAL REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:DC,DACRB
Authorized Official - Phone:703-975-3954
Mailing Address - Street 1:8 PEACE PIPE LN
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-1113
Mailing Address - Country:US
Mailing Address - Phone:703-975-3954
Mailing Address - Fax:540-479-3341
Practice Address - Street 1:2358 PLANK RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4900
Practice Address - Country:US
Practice Address - Phone:540-548-8400
Practice Address - Fax:540-479-3341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001813111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA490568Medicare PIN
VAU78195Medicare UPIN