Healthcare Provider Details

I. General information

NPI: 1942802756
Provider Name (Legal Business Name): SPRING RIDGE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 01/25/2021
Certification Date: 01/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 THOMAS JOHNSON DR STE D
FREDERICK MD
21702-4371
US

IV. Provider business mailing address

66D THOMAS JOHNSON DR
FREDERICK MD
21702
US

V. Phone/Fax

Practice location:
  • Phone: 301-663-7898
  • Fax:
Mailing address:
  • Phone: 301-663-7898
  • 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: EARL FORBES COX
Title or Position: OWNER
Credential:
Phone: 301-663-7898