MEDICARE: MIRIAM E BOVICH PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	23883	MD
2	2251S0007X	Sports Physical Therapist	2305210021	VA
3	2251S0007X	Sports Physical Therapist	871323	DC

General Provider Information

NPI Number	:	1053680314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRIAM E BOVICH PT

Provider Business Mailing Address
First Line	:	20410 CENTURY BLVD
Second Line	:	NRH REGIONAL REHAB - SUITE 215
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-1186
Country	:	US
Telephone Number	:	301-540-6140
Fax Number	:	301-540-5190

Provider Business Practice Location Address
First Line	:	1120 20TH ST NW STE 116
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20036-3406
Country	:	US
Telephone Number	:	202-416-2110
Fax Number	:	202-416-2011

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2011
Last Update Date	:	02/28/2024

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Directions to “ MIRIAM E BOVICH PT” Practice Location

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