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General NPI Number Information
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NPI Number | 1013771757
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Entity Type | Organization
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Legal Business Name | TAILOR-MADE PHYSIOTHERAPY, LLC
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Dates
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Enumeration Date | 02/13/2024
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 7825 TUCKERMAN LN STE 211
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City | POTOMAC
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State | MD
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Zip | 20854-3241
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Country | US
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Telephone | 301-615-2978
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Fax |
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Provider Business Mailing Address
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Address Line | 5750 BOU AVE UNIT 1613
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City | ROCKVILLE
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State | MD
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Zip | 20852-5629
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTIE LEE
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Credential |
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Telephone | 240-687-7376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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