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General NPI Number Information
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NPI Number | 1053680314
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Entity Type | Individual
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Provider Name | MIRIAM E BOVICH PT
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Gender | Female
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Dates
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Enumeration Date | 12/15/2011
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 1120 20TH ST NW STE 116
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City | WASHINGTON
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State | DC
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Zip | 20036-3406
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Country | US
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Telephone | 202-416-2110
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Fax | 202-416-2011
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Provider Business Mailing Address
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Address Line | 20410 CENTURY BLVD NRH REGIONAL REHAB - SUITE 215
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City | GERMANTOWN
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State | MD
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Zip | 20874-1186
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Country | US
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Telephone | 301-540-6140
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Fax | 301-540-5190
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 23883
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 2305210021
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 871323
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License Number State | DC
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