Healthcare Provider Details

I. General information

NPI: 1275459596
Provider Name (Legal Business Name): RYANNE TANAE GLASPER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 PERSHING DR STE 5
SILVER SPRING MD
20910-4436
US

IV. Provider business mailing address

804 PERSHING DR STE 5
SILVER SPRING MD
20910-4436
US

V. Phone/Fax

Practice location:
  • Phone: 202-681-7565
  • Fax:
Mailing address:
  • Phone: 202-681-7565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RYANNE TANAE GLASPER
Title or Position: OWNER
Credential: PT, DPT
Phone: 202-681-7565