Provider Demographics
NPI:1417066408
Name:TURNER, ELIZABETH DICKENS (MPT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:DICKENS
Last Name:TURNER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28103 THREE NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20659-3294
Mailing Address - Country:US
Mailing Address - Phone:301-290-5090
Mailing Address - Fax:301-290-5091
Practice Address - Street 1:28103 THREE NOTCH RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20659-3294
Practice Address - Country:US
Practice Address - Phone:301-290-5090
Practice Address - Fax:301-290-5091
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22415225100000X
2255A2300X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305204910OtherVA STATE PHYSICAL THERAPY
GAPT008413OtherLICENSE #
MD22415OtherSTATE OF MARYLAND