Provider Demographics
NPI:1336448547
Name:UNITED PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:UNITED PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:410-760-1230
Mailing Address - Street 1:7927 RITCHIE HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4343
Mailing Address - Country:US
Mailing Address - Phone:410-760-1230
Mailing Address - Fax:410-760-6705
Practice Address - Street 1:7927 RITCHIE HWY
Practice Address - Street 2:SUITE B
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4343
Practice Address - Country:US
Practice Address - Phone:410-760-1230
Practice Address - Fax:410-760-6705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty