Healthcare Provider Details
I. General information
NPI: 1285561118
Provider Name (Legal Business Name): PT WERKS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9214 RIDGEFIELD CIR
FREDERICK MD
21701-6742
US
IV. Provider business mailing address
9214 RIDGEFIELD CIR
FREDERICK MD
21701-6742
US
V. Phone/Fax
- Phone: 301-712-6143
- Fax:
- Phone:
- 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:
COLIN
VANWERKHOVEN
Title or Position: OWNER
Credential: PT, DPT, CSCS
Phone: 301-712-6143