Healthcare Provider Details

I. General information

NPI: 1730671777
Provider Name (Legal Business Name): EUGENE HELLAMS JR. CMT,CPT,CSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2018
Last Update Date: 06/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 GREENBELT RD STE E210
LANHAM MD
20706-2255
US

IV. Provider business mailing address

9900 GREENBELT RD STE E210
LANHAM MD
20706-2255
US

V. Phone/Fax

Practice location:
  • Phone: 301-651-2371
  • Fax: 855-958-2983
Mailing address:
  • Phone: 301-651-2371
  • Fax: 855-958-2983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number870888
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT130
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: