Healthcare Provider Details

I. General information

NPI: 1508744848
Provider Name (Legal Business Name): ELIZABETH KATHERINE ISAACSON ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2617 VILLAGE LN
SILVER SPRING MD
20906-2305
US

IV. Provider business mailing address

2617 VILLAGE LN
SILVER SPRING MD
20906-2305
US

V. Phone/Fax

Practice location:
  • Phone: 240-271-0125
  • Fax:
Mailing address:
  • Phone: 240-271-0125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number1636
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberA0001776
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: