Basic Information
| Provider Information | |||||||||
| NPI: | 1306942586 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHYSIOTHERAPY ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 NORTH ST | ||||||||
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| City: | ELKTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 219215512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106204795 | ||||||||
| FaxNumber: | 4106204869 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 SPARKS VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | SPARKS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211529330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104721797 | ||||||||
| FaxNumber: | 4104721798 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HOFF | ||||||||
| AuthorizedOfficialFirstName: | JUD | ||||||||
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| AuthorizedOfficialTitleorPosition: | GENERAL MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9016857227 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.