Provider Demographics
NPI:1629570619
Name:METRO SPORTS AND REHAB, LLC
Entity Type:Organization
Organization Name:METRO SPORTS AND REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CHINWAN
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:571-393-0030
Mailing Address - Street 1:7708 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-6644
Mailing Address - Country:US
Mailing Address - Phone:571-393-0030
Mailing Address - Fax:202-380-0508
Practice Address - Street 1:7708 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-6644
Practice Address - Country:US
Practice Address - Phone:571-393-0030
Practice Address - Fax:202-380-0508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-06
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCH030135111N00000X
MDS03573111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty