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General NPI Number Information
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NPI Number | 1093179947
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Entity Type | Organization
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Legal Business Name | GYMFIT PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 04/07/2016
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Provider Practice Location Address
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Address Line | 3317 PLAZA WAY
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City | WALDORF
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State | MD
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Zip | 20603-4862
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Country | US
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Telephone | 301-637-2574
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Fax | 301-576-5043
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Provider Business Mailing Address
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Address Line | 150 POST OFFICE RD 2351
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City | WALDORF
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State | MD
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Zip | 20604-7599
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Country | US
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Telephone | 301-943-3613
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Fax | 301-576-5043
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Authorized Official
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Title or Position | OWNER
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Name | MR. CAMERON JONES
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Credential | PT
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Telephone | 301-637-2574
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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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