Provider Demographics
NPI:1477812451
Name:2 WS LLC
Entity type:Organization
Organization Name:2 WS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WALLOP
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:410-279-0654
Mailing Address - Street 1:156 RITCHIE HWY
Mailing Address - Street 2:STE 100
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-1129
Mailing Address - Country:US
Mailing Address - Phone:410-279-0654
Mailing Address - Fax:
Practice Address - Street 1:156 RITCHIE HWY
Practice Address - Street 2:STE 100
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-1129
Practice Address - Country:US
Practice Address - Phone:410-279-0654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:2 WS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17007261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy