Healthcare Provider Details

I. General information

NPI: 1750487849
Provider Name (Legal Business Name): PHYSIOTHERAPY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1836 GREENE TREE RD
BALTIMORE MD
21208-1381
US

IV. Provider business mailing address

6263 POPLAR AVE STE 801
MEMPHIS TN
38119-4701
US

V. Phone/Fax

Practice location:
  • Phone: 410-486-9992
  • Fax: 410-486-8680
Mailing address:
  • Phone: 901-685-7227
  • Fax: 267-321-2079

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: JANET BECK
Title or Position: MEDICARE COORDINATION
Credential:
Phone: 901-685-7227