Healthcare Provider Details

I. General information

NPI: 1467108258
Provider Name (Legal Business Name): CAM PHYSICAL THERAPY AND WELLNESS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BIDDLE AVE STE 101
NEWARK DE
19702-3982
US

IV. Provider business mailing address

14205 PARK CENTER DR STE 204
LAUREL MD
20707-5252
US

V. Phone/Fax

Practice location:
  • Phone: 301-853-0093
  • Fax:
Mailing address:
  • Phone: 301-412-1927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: CARLOS ARTURO MARTINEZ
Title or Position: PRESIDENT
Credential: PT, DPT
Phone: 301-853-0093