Provider Demographics
NPI:1497059869
Name:WASHINGTON PHYSIODC
Entity Type:Organization
Organization Name:WASHINGTON PHYSIODC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:BAUMSTARK
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT, CHT
Authorized Official - Phone:202-223-8500
Mailing Address - Street 1:1001 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 330
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5504
Mailing Address - Country:US
Mailing Address - Phone:202-223-8500
Mailing Address - Fax:202-379-9299
Practice Address - Street 1:1001 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 330
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5504
Practice Address - Country:US
Practice Address - Phone:202-223-8500
Practice Address - Fax:202-379-9299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT29162251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty