Provider Demographics
NPI:1710649298
Name:TOWSON DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:TOWSON DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIHANG
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-823-6683
Mailing Address - Street 1:110 WEST RD SUITE 201
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2341
Mailing Address - Country:US
Mailing Address - Phone:410-823-6683
Mailing Address - Fax:410-823-7684
Practice Address - Street 1:110 WEST RD SUITE 201
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2341
Practice Address - Country:US
Practice Address - Phone:410-823-6683
Practice Address - Fax:410-823-7684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, ClinicalGroup - Single Specialty