Provider Demographics
NPI:1265494629
Name:TOTAL HEALTH & REHABILITATION, INC
Entity Type:Organization
Organization Name:TOTAL HEALTH & REHABILITATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHODKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:302-477-0800
Mailing Address - Street 1:1303 VEALE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4601
Mailing Address - Country:US
Mailing Address - Phone:302-477-0800
Mailing Address - Fax:302-477-0801
Practice Address - Street 1:1303 VEALE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4601
Practice Address - Country:US
Practice Address - Phone:302-477-0800
Practice Address - Fax:302-477-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1995113363208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001040201Medicaid
DE0001040201Medicaid
DES97321Medicare UPIN
DE0001040201Medicaid