MEDICARE: TOTAL JOINT REHABILITATION INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	PT. 008626	OH

General Provider Information

NPI Number	:	1053355826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL JOINT REHABILITATION INC.

Provider Business Mailing Address
First Line	:	16506 MUNN RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-2065
Country	:	US
Telephone Number	:	216-225-7054
Fax Number	:	216-476-1428

Provider Business Practice Location Address
First Line	:	34143 CENTER RIDGE RD
Second Line	:
City	:	NORTH RIDGEVILLE
State	:	OH
Zip	:	44039-3221
Country	:	US
Telephone Number	:	216-225-7054
Fax Number	:	216-476-1428

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JASON KUCHARSKI
Credential	:	PT
Telephone Number	:	216-225-7054

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	07/21/2022

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