Healthcare Provider Details

I. General information

NPI: 1316197395
Provider Name (Legal Business Name): ANOINTED HANDS PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2008
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 LARGO CENTER DR
LARGO MD
20774-3705
US

IV. Provider business mailing address

PO BOX 3330
CROFTON MD
21114-0330
US

V. Phone/Fax

Practice location:
  • Phone: 301-333-3070
  • Fax: 301-809-8856
Mailing address:
  • Phone: 301-957-4463
  • Fax: 301-809-8856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number18707
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number18707
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number18707
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number18707
License Number StateMD

VIII. Authorized Official

Name: MR. RICHARD HARLAND BASKINS JR.
Title or Position: CEO/PHYSICAL THERAPIST
Credential: PT
Phone: 301-957-4463