Provider Demographics
NPI:1205974383
Name:NORTH CARROLL PHYSICAL THERAPY,INC.
Entity type:Organization
Organization Name:NORTH CARROLL PHYSICAL THERAPY,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREAKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-239-2408
Mailing Address - Street 1:1801 HANOVER PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074
Mailing Address - Country:US
Mailing Address - Phone:410-239-2408
Mailing Address - Fax:410-239-2293
Practice Address - Street 1:1801 HANOVER PIKE
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-2128
Practice Address - Country:US
Practice Address - Phone:410-239-2408
Practice Address - Fax:410-239-2293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD559MMedicare ID - Type Unspecified