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General NPI Number Information
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NPI Number | 1689399396
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Entity Type | Organization
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Legal Business Name | NEW FREEDOM PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 10/05/2022
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 33 ROLLING HILLS RANCH LN
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City | PORT DEPOSIT
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State | MD
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Zip | 21904-1257
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Country | US
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Telephone | 443-267-2622
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Fax |
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Provider Business Mailing Address
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Address Line | 946 CHESAPEAKE DR
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City | HAVRE DE GRACE
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State | MD
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Zip | 21078-3628
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Country | US
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Telephone | 410-652-7230
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MICHAEL TELLUP
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Credential |
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Telephone | 410-652-7230
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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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