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General NPI Number Information
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NPI Number | 1528501913
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Entity Type | Organization
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Legal Business Name | ADVANCED REHAB CENTER LLC
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Dates
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Enumeration Date | 12/02/2016
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 1027 BAY RIDGE AVE
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City | ANNAPOLIS
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State | MD
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Zip | 21403-3031
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Country | US
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Telephone | 410-990-9017
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Fax | 410-990-1085
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Provider Business Mailing Address
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Address Line | 1027 BAY RIDGE AVE
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City | ANNAPOLIS
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State | MD
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Zip | 21403-3031
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Country | US
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Telephone | 410-990-9017
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Fax | 410-990-1085
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL KEVIN MYERS
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Credential |
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Telephone | 410-990-9017
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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 |
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License Number State |
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