Healthcare Provider Details

I. General information

NPI: 1275333767
Provider Name (Legal Business Name): FOREVER FIT PHYSICAL THERAPY & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2025
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5291 CORPORATE DR STE 102
FREDERICK MD
21703-2875
US

IV. Provider business mailing address

5291 CORPORATE DR STE 102
FREDERICK MD
21703-2875
US

V. Phone/Fax

Practice location:
  • Phone: 301-421-1125
  • Fax: 301-500-2175
Mailing address:
  • Phone: 301-421-1125
  • Fax: 301-500-2175

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: KRISTA R FREDERIC
Title or Position: OWNER
Credential:
Phone: 301-421-1125