Provider Demographics
NPI:1801085568
Name:VERONICA WHETSEL MISSION PHYSICAL THERAPY & FITNESS, LLC
Entity type:Organization
Organization Name:VERONICA WHETSEL MISSION PHYSICAL THERAPY & FITNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WHETSEL
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:443-822-3725
Mailing Address - Street 1:895 DORIS DRIVE
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012
Mailing Address - Country:US
Mailing Address - Phone:443-822-3725
Mailing Address - Fax:
Practice Address - Street 1:203 RIDGELY AVE
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401
Practice Address - Country:US
Practice Address - Phone:443-822-3725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20859225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty