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General NPI Number Information
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NPI Number | 1376849141
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Entity Type | Organization
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Legal Business Name | HOLISTIC SOLUTIONS PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 1124 S CHARLES ST
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City | BALTIMORE
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State | MD
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Zip | 21230-4240
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Country | US
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Telephone | 443-790-4472
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Fax |
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Provider Business Mailing Address
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Address Line | 811 S HANOVER ST
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City | BALTIMORE
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State | MD
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Zip | 21230-3901
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Country | US
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Telephone | 443-790-4472
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TARA DIEL
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Credential | PT
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Telephone | 443-790-4472
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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 | 20042
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License Number State | MD
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