Provider Demographics
NPI:1649659392
Name:GREENBELT PHYSICAL THERAPY & SPORTS MEDICINE INC
Entity type:Organization
Organization Name:GREENBELT PHYSICAL THERAPY & SPORTS MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEVINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:PABLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-565-9563
Mailing Address - Street 1:7233 HANOVER PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3600
Mailing Address - Country:US
Mailing Address - Phone:301-474-0315
Mailing Address - Fax:
Practice Address - Street 1:7241 HANOVER PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3604
Practice Address - Country:US
Practice Address - Phone:301-477-1987
Practice Address - Fax:301-477-1988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty