Healthcare Provider Details

I. General information

NPI: 1760477715
Provider Name (Legal Business Name): TOTAL REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 11/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1829 E FRANKLIN ST BLDG #600
CHAPEL HILL NC
27514-5861
US

IV. Provider business mailing address

PO BOX 3456
CHAPEL HILL NC
27515-3456
US

V. Phone/Fax

Practice location:
  • Phone: 919-968-3456
  • Fax: 919-932-3456
Mailing address:
  • Phone: 919-968-3456
  • Fax: 919-932-3456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNC

VIII. Authorized Official

Name: SANDRA LOWE BLACKWOOD
Title or Position: VICE PRESIDENT/CO-OWNER
Credential: PHYSICAL THERAPIST
Phone: 919-968-3456