Provider Demographics
NPI:1962664508
Name:HOWARD, KEN W (MPT)
Entity Type:Individual
Prefix:
First Name:KEN
Middle Name:W
Last Name:HOWARD
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8380 COLESVILLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-6255
Mailing Address - Country:US
Mailing Address - Phone:301-588-7778
Mailing Address - Fax:301-588-0843
Practice Address - Street 1:8380 COLESVILLE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-6255
Practice Address - Country:US
Practice Address - Phone:301-588-7778
Practice Address - Fax:301-588-0843
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD22498225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist