Provider Demographics
NPI:1053857797
Name:GARRETT ORTHOPEDIC PHYSICAL THERAPY & REHABILITATION LLC
Entity Type:Organization
Organization Name:GARRETT ORTHOPEDIC PHYSICAL THERAPY & REHABILITATION LLC
Other - Org Name:GO PT
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:VOELKEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:301-334-5220
Mailing Address - Street 1:13141 GARRETT HWY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-1164
Mailing Address - Country:US
Mailing Address - Phone:301-334-5220
Mailing Address - Fax:301-334-6277
Practice Address - Street 1:13141 GARRETT HWY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1164
Practice Address - Country:US
Practice Address - Phone:301-334-5220
Practice Address - Fax:301-334-6277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCI553OtherMEDICARE RAILROAD
MDE273OtherGHMSI & FEDERAL BLUE CROSS
MDKE79GAOtherCAREFIRST BLUE CROSS BLUE SHIELD
MD215502800Medicaid
IWIF 25-99OtherINJURED WORKERS
MDCI553OtherMEDICARE RAILROAD