Provider Demographics
NPI:1639117377
Name:HARFORD COUNTY WELLNESS CENTER
Entity Type:Organization
Organization Name:HARFORD COUNTY WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUTAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS,PT
Authorized Official - Phone:410-569-4806
Mailing Address - Street 1:PO BOX 652
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-0652
Mailing Address - Country:US
Mailing Address - Phone:410-569-4806
Mailing Address - Fax:410-569-5474
Practice Address - Street 1:3465 BOX HILL CORPORATE CENTER DR
Practice Address - Street 2:SUITE G
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1261
Practice Address - Country:US
Practice Address - Phone:410-569-4806
Practice Address - Fax:410-569-5474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD190532251X0800X
MD02779225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD51647OtherEHP, PRIORITY PARTNERS,
MDLX42HAOtherCAREFIRST BCBS ( MARYLAND
MDT-121OtherFEDERAL BCBS, BLUE CHOICE
MD51647OtherKAISER
MDDA3375OtherRAILROAD MEDICARE
MD2144336OtherALLIANCE
MD2144336OtherOPTIMUM CHOICE
MD4846270001OtherDME POS ASSIGNED
MD4846270001OtherDME POS ASSIGNED
MD51647OtherEHP, PRIORITY PARTNERS,
MD=========OtherAETNA
MDLX42HAOtherCAREFIRST BCBS ( MARYLAND
MDT-121OtherFEDERAL BCBS, BLUE CHOICE
MD2144336OtherOPTIMUM CHOICE