Provider Demographics
NPI:1558452904
Name:PHYSIOTHERAPY ASSOCIATES - UNION REHAB LLC
Entity Type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES - UNION REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIGENFUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-685-7227
Mailing Address - Street 1:211 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5512
Mailing Address - Country:US
Mailing Address - Phone:410-620-4795
Mailing Address - Fax:410-620-4869
Practice Address - Street 1:304 NORTH ST # 306
Practice Address - Street 2:SUITE 4
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5570
Practice Address - Country:US
Practice Address - Phone:410-392-5550
Practice Address - Fax:410-398-6062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD216555Medicare Oscar/Certification