Basic Information
| Provider Information | |||||||||
| NPI: | 1437458783 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STONE | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | LAWRENCE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LMT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11006 VEIRS MILL RD | ||||||||
| Address2: | L15-282 | ||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209022582 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019337827 | ||||||||
| FaxNumber: | 2402900342 | ||||||||
| Practice Location | |||||||||
| Address1: | 11301 AMHERST AVE | ||||||||
| Address2: | 102 | ||||||||
| City: | WHEATON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209024665 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019337827 | ||||||||
| FaxNumber: | 2402900342 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2011 | ||||||||
| LastUpdateDate: | 03/24/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | M03121 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
No ID Information.