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Organization

FAIRFAX REHABILITATION, INCORPORATED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MELANIE ROCHON BUSH PT (PRESIDENT)
(703) 273-9191
Entity
Organization

Contact information

Practice address
10301 DEMOCRACY LN, SUITE 100, FAIRFAX, VA 22030-2545
(703) 273-9191
(703) 273-9213
Mailing address
10301 DEMOCRACY LN, SUITE 100, FAIRFAX, VA 22030-2545
(703) 273-9191
(703) 273-9213

Taxonomy

Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
2305001398
VA
261QR0400X
Rehabilitation Clinic/Center
2305002194
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4979184
VA
Enumeration date
01/09/2006
Last updated
11/30/2011
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