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General NPI Number Information
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NPI Number | 1912930835
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Entity Type | Organization
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Legal Business Name | FITNESS FORUM OF MARYLAND, LLC
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 2448 HOLLY AVE SUITE 200
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3148
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Country | US
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Telephone | 410-295-4941
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Fax | 410-295-5207
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Provider Business Mailing Address
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Address Line | 659 S SALISBURY BLVD SUITE 1B
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City | SALISBURY
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State | MD
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Zip | 21801-5453
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Country | US
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Telephone | 410-831-3226
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Fax | 410-572-4041
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Authorized Official
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Title or Position | REGIONAL MANAGER
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Name | MRS. JANICE M BALDWIN
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Credential |
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Telephone | 410-831-3226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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