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NPI Code Detail

MEDICARE: ABSOLUTE PHYSICAL THERAPY, LLC

MEDICARE: ABSOLUTE PHYSICAL THERAPY, 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
1225100000XPhysical TherapistMD

General Provider Information

NPI Number : 1548539406
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABSOLUTE PHYSICAL THERAPY, LLC
Provider Business Mailing Address
First Line : 3200 CRAIN HWY
Second Line : SUITE 103
City : WALDORF
State : MD
Zip : 20603-4841
Country : US
Telephone Number : 240-419-5101
Fax Number : 240-419-5106
Provider Business Practice Location Address
First Line : 3200 CRAIN HWY
Second Line : SUITE 103
City : WALDORF
State : MD
Zip : 20603-4841
Country : US
Telephone Number : 240-419-5101
Fax Number : 240-419-5106
Authorized Official
Title or Position : MANAGING PARTNER
Name : DR. DERRICK ANTONIO MARTIN
Credential : D.P.T
Telephone Number : 240-419-5101
Provider Enumeration Date : 12/22/2011
Last Update Date : 12/03/2024

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Directions to “ABSOLUTE PHYSICAL THERAPY, LLC ” Practice Location

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