Healthcare Provider Details

I. General information

NPI: 1801432018
Provider Name (Legal Business Name): TOTAL REHABILITATION AND CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 11/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3761 TEAYS VALLEY RD
HURRICANE WV
25526-9705
US

IV. Provider business mailing address

117 STATE ROUTE 34
HURRICANE WV
25526-7004
US

V. Phone/Fax

Practice location:
  • Phone: 304-760-2777
  • Fax: 304-760-1189
Mailing address:
  • Phone: 304-546-2777
  • Fax: 304-760-1189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DARRIN VANSCOY
Title or Position: OWNER
Credential: DC
Phone: 304-546-2777