Provider Demographics
NPI:1255659900
Name:CHESAPEAKE PHYSICAL AQUATIC THERAPY, INC
Entity Type:Organization
Organization Name:CHESAPEAKE PHYSICAL AQUATIC THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-719-8661
Mailing Address - Street 1:PO BOX 21277
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-0777
Mailing Address - Country:US
Mailing Address - Phone:410-719-8661
Mailing Address - Fax:410-719-8996
Practice Address - Street 1:6151 DAYLONG LN
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1639
Practice Address - Country:US
Practice Address - Phone:410-381-7000
Practice Address - Fax:410-381-3779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty