Provider Demographics
NPI:1770721383
Name:ABSOLUTE REHABILITATIVE THERAPY, INC
Entity type:Organization
Organization Name:ABSOLUTE REHABILITATIVE THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:301-220-2316
Mailing Address - Street 1:7501 GREENWAY CENTER DR
Mailing Address - Street 2:SUITE 800
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3514
Mailing Address - Country:US
Mailing Address - Phone:301-220-2316
Mailing Address - Fax:301-220-2319
Practice Address - Street 1:9841 GREENBELT RD STE 103
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-6216
Practice Address - Country:US
Practice Address - Phone:301-220-2316
Practice Address - Fax:301-220-2319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD01302933OtherAMERIGROUP
MDDK5BABOtherCAREFIRST OF MARYLAND
MDQ018OtherCAREFIRST BCBS
MD961002200Medicaid
MD961002200Medicaid