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General NPI Number Information
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NPI Number | 1366812331
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Entity Type | Organization
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Legal Business Name | ATLAS PHYSICAL THERAPY & ASSOCIATES, LLC
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Dates
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Enumeration Date | 10/02/2015
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1406 CRAIN HWY S SUITE 110
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City | GLEN BURNIE
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State | MD
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Zip | 21061-4058
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Country | US
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Telephone | 410-762-2124
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Fax | 410-705-5057
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Provider Business Mailing Address
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Address Line | PO BOX 96224
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City | PHOENIX
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State | AZ
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Zip | 85072-6224
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Country | US
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Telephone | 410-762-2124
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Fax | 410-705-5057
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | ANNA GAYLORD
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Credential |
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Telephone | 678-837-7176
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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 | 22199
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License Number State | MD
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