Healthcare Provider Details

I. General information

NPI: 1174630982
Provider Name (Legal Business Name): TOTAL REHAB, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 05/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2358 PLANK RD
FREDERICKSBURG VA
22401-4900
US

IV. Provider business mailing address

8 PEACE PIPE LN
FREDERICKSBURG VA
22401-1113
US

V. Phone/Fax

Practice location:
  • Phone: 540-548-8400
  • Fax: 540-479-3341
Mailing address:
  • Phone: 703-975-3954
  • Fax: 540-479-3341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number0104001813
License Number StateVA

VIII. Authorized Official

Name: DR. MATTHEW S CHO
Title or Position: CHIROPRACTOR
Credential: D.C.,D.A.C.R.B.
Phone: 703-975-3954