Provider Demographics
NPI:1659669679
Name:FUNK, JOSHUA (DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:FUNK
Suffix:
Gender:M
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1341 HUGHES FORD RD STE 104
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-3134
Mailing Address - Country:US
Mailing Address - Phone:301-798-4838
Mailing Address - Fax:301-798-4876
Practice Address - Street 1:1341 HUGHES FORD RD STE 104
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701
Practice Address - Country:US
Practice Address - Phone:301-798-4838
Practice Address - Fax:301-798-4876
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23730225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist