Healthcare Provider Details
I. General information
NPI: 1801122916
Provider Name (Legal Business Name): EAMAN PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2009
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19785 CRYSTAL ROCK DR STE 309
GERMANTOWN MD
20874-4732
US
IV. Provider business mailing address
19785 CRYSTAL ROCK DR STE 309
GERMANTOWN MD
20874-4732
US
V. Phone/Fax
- Phone: 240-724-6781
- Fax: 888-607-7117
- Phone: 240-724-6781
- Fax: 888-607-7117
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | 23069 |
| License Number State | MD |
VIII. Authorized Official
Name:
TAREK
A
HASSAN
Title or Position: DIRECTOR
Credential:
Phone: 240-686-5225