Healthcare Provider Details

I. General information

NPI: 1639635469
Provider Name (Legal Business Name): RHONDA SUE LAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2019
Last Update Date: 02/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 ARCOLA AVE
SILVER SPRING MD
20902-3401
US

IV. Provider business mailing address

7905 MAPLE LAWN BLVD
FULTON MD
20759-2603
US

V. Phone/Fax

Practice location:
  • Phone: 301-649-2400
  • Fax:
Mailing address:
  • Phone: 410-868-0363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA3281
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: