Healthcare Provider Details

I. General information

NPI: 1225668080
Provider Name (Legal Business Name): BUMP FIT & REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 01/21/2020
Certification Date: 01/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4506 POWDER MILL RD
BELTSVILLE MD
20705-2636
US

IV. Provider business mailing address

4506 POWDER MILL RD
BELTSVILLE MD
20705-2636
US

V. Phone/Fax

Practice location:
  • Phone: 240-484-7757
  • Fax:
Mailing address:
  • Phone:
  • 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: SIGRI REYES
Title or Position: OWNER
Credential: DPT
Phone: 240-484-7757