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General NPI Number Information
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NPI Number | 1487805685
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Entity Type | Organization
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Legal Business Name | HAILE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 03/19/2020
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Provider Practice Location Address
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Address Line | 2152 RENARD CT
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City | ANNAPOLIS
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State | MD
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Zip | 21401-6756
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Country | US
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Telephone | 410-571-1151
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Fax | 410-266-1513
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Provider Business Mailing Address
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Address Line | 116 AMESBURY CT
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City | SEVERNA PARK
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State | MD
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Zip | 21146-1200
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Country | US
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Telephone | 410-647-7326
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ANNE E HAILE
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Credential | PT
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Telephone | 410-571-1151
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 16024
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License Number State | MD
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