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General NPI Number Information
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NPI Number | 1083991277
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Entity Type | Organization
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Legal Business Name | ADVANCED PT & ACUPUNCTURE INC
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Dates
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Enumeration Date | 11/16/2011
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Last Update Date | 11/16/2011
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Provider Practice Location Address
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Address Line | 302 KING FARM BLVD STE 120
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City | ROCKVILLE
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State | MD
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Zip | 20850-5994
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Country | US
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Telephone | 240-361-2225
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Fax | 240-361-0719
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Provider Business Mailing Address
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Address Line | 430 DANBRIDGE ST
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City | GAITHERSBURG
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State | MD
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Zip | 20878-2144
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Country | US
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Telephone | 240-361-2225
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Fax | 240-361-0719
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANDREW BLOCH
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Credential | MSPT,ATC,DOM
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Telephone | 240-361-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | U01848
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 23495
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 22051
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License Number State | MD
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