Healthcare Provider Details

I. General information

NPI: 1629010954
Provider Name (Legal Business Name): CAPITOL REHAB, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 03/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N QUINCY ST 130
ARLINGTON VA
22203-1999
US

IV. Provider business mailing address

801 N QUINCY ST 130
ARLINGTON VA
22203-1999
US

V. Phone/Fax

Practice location:
  • Phone: 703-527-5492
  • Fax:
Mailing address:
  • Phone: 703-527-5492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM EDWARD BOOKER IV
Title or Position: DIRECTOR
Credential: DC
Phone: 703-527-5492