# TOTAL HEALTH & REHAB CHIROPRACTIC-PHYSICAL THERAPY-WELLNESS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033541495
- **Authorized official:** DR. RUSSELL ANTICO D.C. (OWNER)
- **Authorized official phone:** (443) 259-0235

## Contact information

- **Practice address:** 8894 STANFORD BLVD, SUITE 102, COLUMBIA, MD 21045-4794
- **Practice address phone:** (443) 259-0235
- **Mailing address:** 8894 STANFORD BLVD, SUITE 102, COLUMBIA, MD 21045-4794
- **Mailing address phone:** (443) 259-0235

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | S01939 | MD | Yes |

## Other

- **Enumeration date:** 08/07/2013
- **Last updated:** 08/07/2013