Organization
TOTAL REHAB CENTER, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY RANDALL (DIRECTOR/OWNER)
(606) 679-1761
Entity
Organization
Contact information
Practice address
175 MEDPARK DRIVE, SOMERSET, KY 42503-2888
(606) 679-1761
(606) 678-0971
Mailing address
175 MEDPARK DRIVE, SOMERSET, KY 42503-2888
(606) 679-1761
(606) 678-0971
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
225X00000X
Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000225875
BCBS GROUP NUMBER FOR PT
KY
05
—
87031803
—
KY
Enumeration date
07/09/2006
Last updated
03/01/2016
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