Provider Demographics
NPI:1932438868
Name:DENBOW, RAPHAEL JOSHUA II (PT)
Entity Type:Individual
Prefix:
First Name:RAPHAEL
Middle Name:JOSHUA
Last Name:DENBOW
Suffix:II
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4467 OLD BRANCH AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1854
Mailing Address - Country:US
Mailing Address - Phone:301-358-6155
Mailing Address - Fax:301-423-1440
Practice Address - Street 1:4467 OLD BRANCH AVE STE 103
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1854
Practice Address - Country:US
Practice Address - Phone:301-358-6155
Practice Address - Fax:301-423-1440
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-24
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21443225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist