Provider Demographics
NPI:1487204376
Name:GELDART, COLIN G (DPT)
Entity Type:Individual
Prefix:
First Name:COLIN
Middle Name:G
Last Name:GELDART
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5750
Mailing Address - Fax:571-423-5703
Practice Address - Street 1:22505 LANDMARK CT STE 215
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-6502
Practice Address - Country:US
Practice Address - Phone:703-726-1616
Practice Address - Fax:703-726-1613
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305213173225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist