Provider Demographics
NPI:1760881494
Name:PHYSIOTHERAPY ASSOCIATES
Entity Type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROXZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-596-2500
Mailing Address - Street 1:1132 ANNAPOLIS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1647
Mailing Address - Country:US
Mailing Address - Phone:410-672-8091
Mailing Address - Fax:410-672-8094
Practice Address - Street 1:1132 ANNAPOLIS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1647
Practice Address - Country:US
Practice Address - Phone:410-672-8091
Practice Address - Fax:410-672-8094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25016261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy