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General NPI Number Information
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NPI Number | 1962688606
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Entity Type | Organization
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Legal Business Name | DRM BODY IMAGE
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Dates
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Enumeration Date | 01/11/2008
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Last Update Date | 01/11/2008
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Provider Practice Location Address
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Address Line | 5412 MARSHALLS CHOICE DR SUITE #1B
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City | BOWIE
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State | MD
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Zip | 20720-6309
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Country | US
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Telephone | 301-464-1006
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Fax | 301-464-2534
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Provider Business Mailing Address
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Address Line | 5412 MARSHALLS CHOICE DR SUITE #1B
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City | BOWIE
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State | MD
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Zip | 20720
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DENISE MURRAY
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Credential |
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Telephone | 202-905-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | A2625
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License Number State | MD
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