Healthcare Provider Details

I. General information

NPI: 1629344353
Provider Name (Legal Business Name): AMN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2012
Last Update Date: 03/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3227 BEL PRE RD
SILVER SPRING MD
20906-2423
US

IV. Provider business mailing address

1912 POWELL DR APT 3A
CHAMBERSBURG PA
17201-4252
US

V. Phone/Fax

Practice location:
  • Phone: 301-871-2000
  • Fax:
Mailing address:
  • Phone: 717-729-8773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberA3561
License Number StateMD

VIII. Authorized Official

Name: JOSHUA SEVILLE
Title or Position: PHYSICAL THERAPIST ASSISTANT
Credential:
Phone: 717-729-8773