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General NPI Number Information
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NPI Number | 1154618023
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Entity Type | Organization
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Legal Business Name | MARYLAND INJURY CENTER, LLC
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 06/29/2011
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Provider Practice Location Address
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Address Line | 3321 TOLEDO TER SUITE 204
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City | HYATTSVILLE
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State | MD
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Zip | 20782-4150
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Country | US
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Telephone | 301-853-1516
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Fax | 301-853-1517
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Provider Business Mailing Address
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Address Line | 3321 TOLEDO TER SUITE 204
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City | HYATTSVILLE
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State | MD
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Zip | 20782-4150
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Country | US
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Telephone | 301-853-1516
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Fax | 301-853-1517
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Authorized Official
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Title or Position | OFFICE DIRECTOR
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Name | MR. ROBERSON LAPIERRE
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Credential |
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Telephone | 301-853-1516
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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 | 03591
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License Number State | MD
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