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General NPI Number Information
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NPI Number | 1275146797
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Entity Type | Organization
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Legal Business Name | VIVA PHYSICAL THERAPY
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Dates
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Enumeration Date | 08/25/2020
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 4600 POWDER MILL RD
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City | BELTSVILLE
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State | MD
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Zip | 20705-2675
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Country | US
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Telephone | 240-793-1278
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Fax |
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Provider Business Mailing Address
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Address Line | 7277 CALM SUNSET
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City | COLUMBIA
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State | MD
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Zip | 21046-3400
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Country | US
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Telephone | 240-793-1278
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Fax |
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | TRACY R THOMAS
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Credential |
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Telephone | 410-663-4036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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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 |
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License Number State |
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