Provider Demographics
NPI:1710361621
Name:RATHOD, RESHMA PATEL (PT)
Entity Type:Individual
Prefix:
First Name:RESHMA
Middle Name:PATEL
Last Name:RATHOD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 EDSON LN
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3107
Mailing Address - Country:US
Mailing Address - Phone:301-881-9313
Mailing Address - Fax:301-881-9312
Practice Address - Street 1:5410 EDSON LN
Practice Address - Street 2:SUITE 350
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3107
Practice Address - Country:US
Practice Address - Phone:301-881-9313
Practice Address - Fax:301-881-9312
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18266225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist