Provider Demographics
NPI:1548410228
Name:PREMIER ACTION THERAPY INC.
Entity Type:Organization
Organization Name:PREMIER ACTION THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:S
Authorized Official - Last Name:THORPE
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:202-251-5448
Mailing Address - Street 1:8886 GOOSE LANDING CIRCLE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2173
Mailing Address - Country:US
Mailing Address - Phone:202-251-5448
Mailing Address - Fax:866-292-5295
Practice Address - Street 1:8886 GOOSE LANDING CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2173
Practice Address - Country:US
Practice Address - Phone:202-251-5448
Practice Address - Fax:866-292-5295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0002126114261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy