Provider Demographics
NPI:1184677601
Name:CENTERIMT WASHINGTON DC INC
Entity type:Organization
Organization Name:CENTERIMT WASHINGTON DC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-466-8881
Mailing Address - Street 1:900 19TH ST NW
Mailing Address - Street 2:STE 250
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-2105
Mailing Address - Country:US
Mailing Address - Phone:202-466-8881
Mailing Address - Fax:
Practice Address - Street 1:900 19TH ST NW
Practice Address - Street 2:STE 250
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-2105
Practice Address - Country:US
Practice Address - Phone:202-466-8881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
#GO1820Medicare ID - Type Unspecified