Provider Demographics
NPI:1245979962
Name:ONCOLOGY AND PELVIC HEALTH PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:ONCOLOGY AND PELVIC HEALTH PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORA
Authorized Official - Middle Name:SHANNON
Authorized Official - Last Name:JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:202-987-3411
Mailing Address - Street 1:4401 E WEST HWY STE 303
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4523
Mailing Address - Country:US
Mailing Address - Phone:202-987-3411
Mailing Address - Fax:202-998-3403
Practice Address - Street 1:4401 E WEST HWY STE 202
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4541
Practice Address - Country:US
Practice Address - Phone:202-987-3411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty