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General NPI Number Information
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NPI Number | 1952671075
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Entity Type | Organization
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Legal Business Name | MONTCLAIRE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 01/05/2012
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 700 MONTCLAIRE AVE SUITE A
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City | FREDERICK
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State | MD
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Zip | 21701-4577
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Country | US
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Telephone | 301-620-7777
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Fax | 301-769-5773
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Provider Business Mailing Address
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Address Line | 700 MONTCLAIRE AVE SUITE A
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City | FREDERICK
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State | MD
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Zip | 21701-4577
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Country | US
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Telephone | 301-620-7777
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Fax | 301-769-5773
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Authorized Official
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Title or Position | PT
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Name | MRS. MICHELLE JOY BIEN-AIME
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Credential | PT
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Telephone | 301-620-7777
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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 | 20593
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License Number State | MD
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