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General NPI Number Information
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NPI Number | 1801046172
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Entity Type | Organization
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Legal Business Name | REHABILITATION OF FREDERICK
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 85 THOMAS JOHNSON CT STE C
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City | FREDERICK
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State | MD
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Zip | 21702-4331
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Country | US
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Telephone | 301-682-9110
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Fax |
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Provider Business Mailing Address
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Address Line | 85 THOMAS JOHNSON CT STE C
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City | FREDERICK
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State | MD
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Zip | 21702-4331
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Country | US
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Telephone | 301-682-9110
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TIMOTHY V. JONES
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Credential | OTR/L, CHT
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Telephone | 301-982-9110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 04628
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License Number State | MD
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