Healthcare Provider Details

I. General information

NPI: 1124267083
Provider Name (Legal Business Name): KESLER PHYSICALMASSAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2009
Last Update Date: 04/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8828 BRIERLY RD
CHEVY CHASE MD
20815-4752
US

IV. Provider business mailing address

8828 BRIERLY RD
CHEVY CHASE MD
20815-4752
US

V. Phone/Fax

Practice location:
  • Phone: 301-602-3551
  • Fax:
Mailing address:
  • Phone: 301-602-3551
  • 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: MS. MAY E KESLER
Title or Position: SOLE PROPRIETOR, OWNER
Credential: MTH, PT
Phone: 301-602-3551