Provider Demographics
NPI:1033640032
Name:WHITE MARSH PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:WHITE MARSH PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEYMORE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:866-526-8088
Mailing Address - Street 1:9114 PHILADELPHIA RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4345
Mailing Address - Country:US
Mailing Address - Phone:866-526-8088
Mailing Address - Fax:443-451-8229
Practice Address - Street 1:9114 PHILADELPHIA RD
Practice Address - Street 2:SUITE 212
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4345
Practice Address - Country:US
Practice Address - Phone:866-526-8088
Practice Address - Fax:443-451-8229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty