Provider Demographics
NPI:1093248452
Name:OPTIMIZE THERAPY AND FITNESS LLC
Entity Type:Organization
Organization Name:OPTIMIZE THERAPY AND FITNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:301-356-5500
Mailing Address - Street 1:10981 JOHNS HOPKINS RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-6002
Mailing Address - Country:US
Mailing Address - Phone:301-356-5500
Mailing Address - Fax:800-356-5502
Practice Address - Street 1:10981 JOHNS HOPKINS RD
Practice Address - Street 2:SUITE 210
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-6002
Practice Address - Country:US
Practice Address - Phone:301-356-5500
Practice Address - Fax:800-356-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2000X
MD20849261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy