Provider Demographics
NPI:1134442783
Name:PROACTIVE HAND AND PHYSICAL THERAPY
Entity type:Organization
Organization Name:PROACTIVE HAND AND PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRET
Authorized Official - Middle Name:
Authorized Official - Last Name:GREBOWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CHT
Authorized Official - Phone:301-545-1677
Mailing Address - Street 1:9420 KEY WEST AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3334
Mailing Address - Country:US
Mailing Address - Phone:301-545-1677
Mailing Address - Fax:
Practice Address - Street 1:9420 KEY WEST AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6332
Practice Address - Country:US
Practice Address - Phone:301-545-1677
Practice Address - Fax:301-545-1675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-10
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy