Provider Demographics
NPI:1497263578
Name:PROFLEX PHYSICAL THERAPY OF MARYLAND, LLC
Entity Type:Organization
Organization Name:PROFLEX PHYSICAL THERAPY OF MARYLAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-932-4785
Mailing Address - Street 1:PO BOX 791217
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-1217
Mailing Address - Country:US
Mailing Address - Phone:301-932-4786
Mailing Address - Fax:301-932-4789
Practice Address - Street 1:22738 MAPLE RD STE 102
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-3347
Practice Address - Country:US
Practice Address - Phone:301-363-0539
Practice Address - Fax:301-363-4794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-11
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty