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General NPI Number Information
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NPI Number | 1396880100
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Entity Type | Organization
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Legal Business Name | POOLESVILLE PHYSICAL THERAPY
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 19628 FISHER AVE
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City | POOLESVILLE
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State | MD
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Zip | 20837-2065
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Country | US
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Telephone | 301-349-5443
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Fax | 301-349-2074
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Provider Business Mailing Address
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Address Line | 19628 FISHER AVE
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City | POOLESVILLE
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State | MD
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Zip | 20837-2065
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Country | US
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Telephone | 301-349-5443
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Fax | 301-349-2074
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Authorized Official
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Title or Position | OWNER
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Name | MRS. PATRICIA KAPSIAK HESS
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Credential | PT
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Telephone | 301-349-5443
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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 | 15401
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License Number State | MD
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