Healthcare Provider Details

I. General information

NPI: 1316376122
Provider Name (Legal Business Name): METROPOLITAN PHYSICAL THERAPY & FITNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2013
Last Update Date: 11/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8241 GEORGIA AVE STE 102
SILVER SPRING MD
20910-4510
US

IV. Provider business mailing address

8241 GEORGIA AVE STE 102
SILVER SPRING MD
20910-4510
US

V. Phone/Fax

Practice location:
  • Phone: 301-270-2525
  • Fax: 301-589-8917
Mailing address:
  • Phone: 301-270-2525
  • Fax: 301-589-8917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number14547
License Number StateMD

VIII. Authorized Official

Name: MRS. KHADIJA NDIAYE
Title or Position: OFFICE MANAGER
Credential:
Phone: 301-270-2525