Healthcare Provider Details

I. General information

NPI: 1780220335
Provider Name (Legal Business Name): CRAFT PHYSIOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2019
Last Update Date: 09/06/2023
Certification Date: 01/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E WEST HWY APT 624
SILVER SPRING MD
20910-3257
US

IV. Provider business mailing address

1400 E WEST HWY APT 624
SILVER SPRING MD
20910-3257
US

V. Phone/Fax

Practice location:
  • Phone: 240-203-8189
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PHILLIP VANPELT
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: DPT
Phone: 908-868-9180