Healthcare Provider Details
I. General information
NPI: 1518118926
Provider Name (Legal Business Name): ANOINTED HANDS PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2008
Last Update Date: 10/03/2008
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
- Phone: 301-333-3070
- Fax: 301-809-8856
- Phone: 301-957-4463
- Fax: 301-809-8856
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251G0304X |
| Taxonomy | Geriatric Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 17802 |
| License Number State | MD |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MRS.
LISA
HOPE
BASKINS
Title or Position: VICE PRESIDENT/PHYSICAL THERAPIST
Credential: MPT
Phone: 301-957-4463