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General NPI Number Information
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NPI Number | 1649293960
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Entity Type | Individual
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Provider Name | STACY EICHWALD KING MSPT, CIMT
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6410 ROCKLEDGE DR. #301
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City | BETHESDA
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State | MD
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Zip | 20817
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Country | US
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Telephone | 301-897-0357
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Fax | 301-897-2148
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Provider Business Mailing Address
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Address Line | 489 WINDING ROSE DR.
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City | ROCKVILLE
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State | MD
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Zip | 20850
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Country | US
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Telephone | 301-340-7653
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Fax | 301-340-7653
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 19573
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License Number State | MD
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