Provider Demographics
NPI:1689642696
Name:CHESTERTOWN PHYSICAL THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:CHESTERTOWN PHYSICAL THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAINBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:410-778-6565
Mailing Address - Street 1:818 HIGH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1152
Mailing Address - Country:US
Mailing Address - Phone:410-778-6565
Mailing Address - Fax:410-778-6536
Practice Address - Street 1:818 HIGH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1152
Practice Address - Country:US
Practice Address - Phone:410-778-6565
Practice Address - Fax:410-778-6536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15022225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0856120001Medicare NSC
MD216582Medicare PIN