Provider Demographics
NPI:1730406513
Name:TOTAL REHAB SERVICES P.A.
Entity type:Organization
Organization Name:TOTAL REHAB SERVICES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/SPEECH PATHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:MCCUISTON
Authorized Official - Last Name:BURNETT
Authorized Official - Suffix:
Authorized Official - Credentials:CCCA/SLP
Authorized Official - Phone:803-261-5958
Mailing Address - Street 1:9600 TWO NOTCH ROAD
Mailing Address - Street 2:#24-28
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223
Mailing Address - Country:US
Mailing Address - Phone:803-736-5540
Mailing Address - Fax:803-699-0951
Practice Address - Street 1:9600 TWO NOTCH RD
Practice Address - Street 2:SUITE #24-28
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-4304
Practice Address - Country:US
Practice Address - Phone:803-736-5540
Practice Address - Fax:803-699-0951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2448261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech