Provider Demographics
NPI:1326752031
Name:THIS DOCTOR MAKES HOUSECALLS LLC
Entity Type:Organization
Organization Name:THIS DOCTOR MAKES HOUSECALLS LLC
Other - Org Name:THIS DOCTOR MAKES HOUSECALLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMAEL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:202-751-1882
Mailing Address - Street 1:7404 EXECUTIVE PL STE 400
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-6228
Mailing Address - Country:US
Mailing Address - Phone:240-384-6404
Mailing Address - Fax:888-388-0828
Practice Address - Street 1:7404 EXECUTIVE PL STE 400
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-6228
Practice Address - Country:US
Practice Address - Phone:240-384-6404
Practice Address - Fax:888-388-0828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty