Healthcare Provider Details

I. General information

NPI: 1053536326
Provider Name (Legal Business Name): TRI REHAB OF GERMANTOWN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 06/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19733 EXECUTIVE PARK CIR
GERMANTOWN MD
20874-2642
US

IV. Provider business mailing address

19733 EXECUTIVE PARK CIR
GERMANTOWN MD
20874-2642
US

V. Phone/Fax

Practice location:
  • Phone: 301-540-4700
  • Fax: 301-540-4721
Mailing address:
  • Phone: 301-540-4700
  • Fax: 301-540-4721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIZABETH MARIE BIRRER
Title or Position: OWNER
Credential: PT
Phone: 301-540-4700