Provider Demographics
NPI:1568124394
Name:OASIS PT & PELVIC HEALTH, L.L.C.
Entity Type:Organization
Organization Name:OASIS PT & PELVIC HEALTH, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WORTHY-OKOLO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:301-433-3550
Mailing Address - Street 1:324 MAIN ST UNIT 92
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20725-7504
Mailing Address - Country:US
Mailing Address - Phone:301-433-3550
Mailing Address - Fax:
Practice Address - Street 1:10102B AMERICAN PHAROAH LN
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-2086
Practice Address - Country:US
Practice Address - Phone:301-433-3550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-08
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy