Healthcare Provider Details

I. General information

NPI: 1700540168
Provider Name (Legal Business Name): CAM PHYSICAL THERAPY AND WELLNESS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2021
Last Update Date: 10/22/2021
Certification Date: 10/22/2021
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: 301-853-0093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

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