Healthcare Provider Details

I. General information

NPI: 1518384015
Provider Name (Legal Business Name): JEWELS THERAPY CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2014
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 WALKER AVE
BALTIMORE MD
21208-4022
US

IV. Provider business mailing address

31 WALKER AVE
BALTIMORE MD
21208-4022
US

V. Phone/Fax

Practice location:
  • Phone: 410-415-3515
  • Fax:
Mailing address:
  • Phone: 410-415-3515
  • Fax: 443-459-9550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JULES FUCHS
Title or Position: DIRECTOR
Credential:
Phone: 410-415-3515