Provider Demographics
NPI:1316376122
Name:METROPOLITAN PHYSICAL THERAPY & FITNESS CENTER, LLC
Entity Type:Organization
Organization Name:METROPOLITAN PHYSICAL THERAPY & FITNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KHADIJA
Authorized Official - Middle Name:
Authorized Official - Last Name:NDIAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-270-2525
Mailing Address - Street 1:8241 GEORGIA AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4510
Mailing Address - Country:US
Mailing Address - Phone:301-270-2525
Mailing Address - Fax:301-589-8917
Practice Address - Street 1:8241 GEORGIA AVE STE 102
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4510
Practice Address - Country:US
Practice Address - Phone:301-270-2525
Practice Address - Fax:301-589-8917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14547261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy