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General NPI Number Information
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NPI Number | 1972837078
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Entity Type | Organization
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Legal Business Name | NOVACARE
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Dates
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Enumeration Date | 09/23/2009
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 1215 ANNAPOLIS RD
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City | ODENTON
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State | MD
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Zip | 21113-1344
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Country | US
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Telephone | 410-551-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 4905 NAPLES AVE
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City | BELTSVILLE
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State | MD
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Zip | 20705-1836
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Country | US
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Telephone | 301-704-5362
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR/PHYSICAL THERAPIST
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Name | MRS. DIANA HOROWITZ
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Credential | MPT
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Telephone | 410-551-0123
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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 | 23051
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License Number State | MD
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