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General NPI Number Information
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NPI Number | 1487490850
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Entity Type | Organization
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Legal Business Name | SUMMIT NEUROREHABILITATION AND WELLNESS LLC
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Dates
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Enumeration Date | 07/05/2024
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 3401 38TH ST NW APT 725
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City | WASHINGTON
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State | DC
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Zip | 20016-3044
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Country | US
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Telephone | 410-924-9503
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Fax |
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Provider Business Mailing Address
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Address Line | 919 W 34TH STREET #50278 SMB #65067
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City | BALTIMORE
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State | MD
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Zip | 21211
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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 | OWNER, PHYSICAL THERAPIST
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Name | DR. BRADLEY C MILLER
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Credential | PT, DPT, NCS, CSCS
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Telephone | 410-924-9503
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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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Taxonomy #2
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Taxonomy Code | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number |
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License Number State |
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