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General NPI Number Information
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NPI Number | 1306447008
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Entity Type | Organization
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Legal Business Name | NOL PHYSICAL THERAPY, L.L.C.
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Dates
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Enumeration Date | 11/08/2020
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 6620 CRAIN HWY STE 101
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City | LA PLATA
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State | MD
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Zip | 20646-4273
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Country | US
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Telephone | 301-861-4009
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Fax | 301-861-4032
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Provider Business Mailing Address
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Address Line | 6620 CRAIN HWY STE 101
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City | LA PLATA
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State | MD
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Zip | 20646-4273
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Country | US
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Telephone | 301-861-4009
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Fax | 301-861-4032
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Authorized Official
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Title or Position | CLINICAL DIRECTOR/OWNER
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Name | SHERWIN RODRIGUEZ NOL
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Credential | PT
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Telephone | 301-861-4009
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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 |
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License Number State |
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