Healthcare Provider Details

I. General information

NPI: 1073279147
Provider Name (Legal Business Name): ONWARD FREDERICK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1828 ROSEMONT AVE STE C
FREDERICK MD
21702-8250
US

IV. Provider business mailing address

1828 ROSEMONT AVE STE C
FREDERICK MD
21702-8250
US

V. Phone/Fax

Practice location:
  • Phone: 301-202-4362
  • Fax:
Mailing address:
  • Phone: 301-202-4362
  • 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: ZACHERY AGUIAR
Title or Position: CEO
Credential: PT
Phone: 978-866-8032