Healthcare Provider Details

I. General information

NPI: 1750929527
Provider Name (Legal Business Name): KELSEY PAIGE ZAGAMI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY PAIGE LARGER DPT

II. Dates (important events)

Enumeration Date: 12/12/2019
Last Update Date: 12/15/2022
Certification Date: 12/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15204 OMEGA DR STE 310
ROCKVILLE MD
20850-4816
US

IV. Provider business mailing address

15204 OMEGA DR STE 310
ROCKVILLE MD
20850-4816
US

V. Phone/Fax

Practice location:
  • Phone: 240-361-9000
  • Fax: 240-361-9001
Mailing address:
  • Phone: 240-361-9000
  • Fax: 240-361-9001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number27761
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: