Provider Demographics
NPI:1255415436
Name:GML PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:GML PHYSICAL THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:COADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-638-0700
Mailing Address - Street 1:2217 COMMERCE RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2565
Mailing Address - Country:US
Mailing Address - Phone:410-638-0700
Mailing Address - Fax:410-638-6790
Practice Address - Street 1:2217 COMMERCE RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2565
Practice Address - Country:US
Practice Address - Phone:410-638-0700
Practice Address - Fax:410-638-6790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS272OtherCARE FIRST HMO
MD2660198OtherAETNA HMO
MDLX64GMOtherCAERFIRST BC/BS
MD7506321OtherAETNA PPO
MD2660198OtherAETNA HMO
MDS272OtherCARE FIRST HMO