Provider Demographics
NPI:1154339877
Name:ARLINGTON REHABILITATION, PLLC
Entity type:Organization
Organization Name:ARLINGTON REHABILITATION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:703-248-0006
Mailing Address - Street 1:1715 N GEORGE MASON DR
Mailing Address - Street 2:SUITE 402
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3609
Mailing Address - Country:US
Mailing Address - Phone:703-248-0006
Mailing Address - Fax:703-248-0007
Practice Address - Street 1:1715 N GEORGE MASON DR
Practice Address - Street 2:SUITE 402
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3609
Practice Address - Country:US
Practice Address - Phone:703-248-0006
Practice Address - Fax:703-248-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0001K171OtherBCBS- ANTHEM
0001K171OtherBCBS- ANTHEM