Healthcare Provider Details

I. General information

NPI: 1811261654
Provider Name (Legal Business Name): EAMAN PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2012
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16220 FREDERICK RD STE 120
GAITHERSBURG MD
20877-4039
US

IV. Provider business mailing address

16220 FREDERICK RD STE 120
GAITHERSBURG MD
20877-4039
US

V. Phone/Fax

Practice location:
  • Phone: 240-724-6781
  • Fax: 888-607-7117
Mailing address:
  • Phone: 240-724-6781
  • Fax: 888-607-7117

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: MR. TAREK A HASSAN
Title or Position: DIRECTOR
Credential:
Phone: 240-393-8179