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General NPI Number Information
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NPI Number | 1336662139
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Entity Type | Organization
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Legal Business Name | GEORGALLAS PHYSIOTHERAPY, LLC
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Dates
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Enumeration Date | 07/24/2017
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Last Update Date | 07/24/2017
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Provider Practice Location Address
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Address Line | 11820 GREGERSCROFT RD
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City | POTOMAC
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State | MD
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Zip | 20854-2143
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Country | US
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Telephone | 240-388-5035
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Fax |
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Provider Business Mailing Address
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Address Line | 11820 GREGERSCROFT RD
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City | POTOMAC
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State | MD
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Zip | 20854-2143
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST, OWNER/FOUNDER
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Name | DR. LAMBROS C GEORGALLAS
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Credential | DPT
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Telephone | 240-388-5035
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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 | 22800
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License Number State | MD
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