MEDICARE: DRAYER PHYSICAL THERAPY OF MARYLAND LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1184049967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRAYER PHYSICAL THERAPY OF MARYLAND LLC

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	1694 WATER TOWER WAY STE 107
Second Line	:
City	:	FOREST HILL
State	:	MD
Zip	:	21050-1774
Country	:	US
Telephone Number	:	410-420-2257
Fax Number	:	410-420-2267

Authorized Official
Title or Position	:	CFO
Name	:	THOMAS BRYAN BARGANIER
Credential	:
Telephone Number	:	205-536-7602

Provider Enumeration Date	:	03/03/2014
Last Update Date	:	09/13/2023

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