Healthcare Provider Details

I. General information

NPI: 1093639494
Provider Name (Legal Business Name): ISAIAH MINNS PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 HUGHES FORD RD STE 104
FREDERICK MD
21701-3134
US

IV. Provider business mailing address

1341 HUGHES FORD RD STE 104
FREDERICK MD
21701-3134
US

V. Phone/Fax

Practice location:
  • Phone: 301-798-4838
  • Fax:
Mailing address:
  • Phone: 301-798-4838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number30975
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number30975
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number30975
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: