Provider Demographics
NPI:1184788440
Name:CONZE, MARGARET GRUNOW (PT, MSPT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:GRUNOW
Last Name:CONZE
Suffix:
Gender:F
Credentials:PT, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 RESEARCH BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3172
Mailing Address - Country:US
Mailing Address - Phone:301-978-7730
Mailing Address - Fax:301-978-7731
Practice Address - Street 1:1801 RESEARCH BLVD STE 103
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3172
Practice Address - Country:US
Practice Address - Phone:301-978-7730
Practice Address - Fax:301-978-7731
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20498225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
014116M40Medicare ID - Type Unspecified