Healthcare Provider Details

I. General information

NPI: 1437013521
Provider Name (Legal Business Name): WELLCARE PHYSICAL & OCCUPATIONAL THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SCIENCE PARK
FROSTBURG MD
21532-2024
US

IV. Provider business mailing address

1 SCIENCE PARK
FROSTBURG MD
21532-2024
US

V. Phone/Fax

Practice location:
  • Phone: 301-729-2235
  • Fax: 240-437-4589
Mailing address:
  • Phone: 301-729-2235
  • Fax: 240-437-4589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: GREG DULL
Title or Position: BUSINESS MANAGER
Credential: BUSINESS MANAGER
Phone: 814-585-2770