Provider Demographics
NPI:1033329420
Name:SPRINGELPTA, EUGENE ANTHONY (LPTA)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:ANTHONY
Last Name:SPRINGELPTA
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20055 APPLEDOWRE CIR APT 13
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-5726
Mailing Address - Country:US
Mailing Address - Phone:301-919-6025
Mailing Address - Fax:
Practice Address - Street 1:FRIENDS NURSING HOME
Practice Address - Street 2:17401 NORWOOD ROAD
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860
Practice Address - Country:US
Practice Address - Phone:301-924-7527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1636225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant