Provider Demographics
NPI:1811599616
Name:ALPHA PROJECT PHYZIO LLC
Entity Type:Organization
Organization Name:ALPHA PROJECT PHYZIO LLC
Other - Org Name:ALPHA PROJECT PHYZIO & PERFORMANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:315-271-8675
Mailing Address - Street 1:4920B MERIDIAN WAY APT 22
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-6898
Mailing Address - Country:US
Mailing Address - Phone:315-271-8675
Mailing Address - Fax:
Practice Address - Street 1:4920B MERIDIAN WAY APT 22
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-6898
Practice Address - Country:US
Practice Address - Phone:315-271-8675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy