Healthcare Provider Details

I. General information

NPI: 1033329420
Provider Name (Legal Business Name): EUGENE ANTHONY SPRINGELPTA LPTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FRIENDS NURSING HOME 17401 NORWOOD ROAD
SANDY SPRING MD
20860
US

IV. Provider business mailing address

20055 APPLEDOWRE CIR APT 13
GERMANTOWN MD
20876-5726
US

V. Phone/Fax

Practice location:
  • Phone: 301-924-7527
  • Fax:
Mailing address:
  • Phone: 301-919-6025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA1636
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: