Provider Demographics
NPI:1952593022
Name:LEMOINE & ASSOCIATES PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:LEMOINE & ASSOCIATES PHYSICAL THERAPY LLC
Other - Org Name:LEMOINE PHYSICAL THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER / PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:LEMOINE
Authorized Official - Suffix:
Authorized Official - Credentials:PT,DPT
Authorized Official - Phone:443-415-3055
Mailing Address - Street 1:1232 RACE RD
Mailing Address - Street 2:UNIT 203
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-2351
Mailing Address - Country:US
Mailing Address - Phone:410-918-0080
Mailing Address - Fax:410-918-0050
Practice Address - Street 1:1232 RACE RD
Practice Address - Street 2:UNIT 203
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-2351
Practice Address - Country:US
Practice Address - Phone:410-918-0080
Practice Address - Fax:410-918-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20651174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD=========OtherEIN NUMBER