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General NPI Number Information
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NPI Number | 1558559021
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Entity Type | Organization
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Legal Business Name | ARUNDEL PHYSICAL THERAPY & FITNESS, LLC
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Dates
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Enumeration Date | 10/10/2007
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 1418 SAYBROOKE CT
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City | PASADENA
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State | MD
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Zip | 21122-5936
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Country | US
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Telephone | 410-916-3689
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Fax |
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Provider Business Mailing Address
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Address Line | 1418 SAYBROOKE CT
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City | PASADENA
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State | MD
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Zip | 21122-5936
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Country | US
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Telephone | 410-916-3689
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MR. GORDON WILLIAM WARD JR.
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Credential | PT
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Telephone | 410-916-3689
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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 | 19304
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License Number State | MD
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