Provider Demographics
NPI:1497786362
Name:COLUMBIA PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:COLUMBIA PHYSICAL THERAPY LLC
Other - Org Name:COLUMBIA PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:MS
Authorized Official - First Name:MALIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHEED
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:410-905-9378
Mailing Address - Street 1:8186 LARK BROWN RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6433
Mailing Address - Country:US
Mailing Address - Phone:410-905-9378
Mailing Address - Fax:
Practice Address - Street 1:8186 LARK BROWN RD
Practice Address - Street 2:SUITE 302
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6433
Practice Address - Country:US
Practice Address - Phone:410-799-4232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD998MMedicare ID - Type UnspecifiedPHYSICAL THERAPY CLINIC