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General NPI Number Information
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NPI Number | 1750792958
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Entity Type | Organization
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Legal Business Name | DRAYER PHYSCIAL THERAPY OF MARYLAND, LLC
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Dates
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Enumeration Date | 05/12/2014
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 7850 ROSSVILLE BLVD STE 206-208
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City | BALTIMORE
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State | MD
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Zip | 21236-3934
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Country | US
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Telephone | 410-931-2738
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Fax | 410-931-2739
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Provider Business Mailing Address
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Address Line | 8205 PRESIDENTS DR FL 2
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City | HUMMELSTOWN
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State | PA
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Zip | 17036-8621
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Country | US
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Telephone | 717-839-2159
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Fax | 717-565-1104
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Authorized Official
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Title or Position | MANAGER OF PAYOR & PROV ENROLLMENT
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Name | LISA BENETTO
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Credential |
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Telephone | 423-238-8923
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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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