Healthcare Provider Details
I. General information
NPI: 1639351307
Provider Name (Legal Business Name): J & JS PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/04/2007
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10415 SOUTHERN MARYLAND BLVD
DUNKIRK MD
20754-2734
US
IV. Provider business mailing address
PO BOX 205
DUNKIRK MD
20754-0205
US
V. Phone/Fax
- Phone: 410-257-2589
- Fax:
- Phone: 410-257-2589
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
T
SAUL
Title or Position: OWNER
Credential:
Phone: 410-257-2589