MEDICARE: ROOTED STRENGTH PHYSICAL THERAPY

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1164369435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROOTED STRENGTH PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	7250 PRESERVATION CT
Second Line	:
City	:	FULTON
State	:	MD
Zip	:	20759-2304
Country	:	US
Telephone Number	:	443-875-5960
Fax Number	:

Provider Business Practice Location Address
First Line	:	7175 OAKLAND MILLS RD STE M
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046-1570
Country	:	US
Telephone Number	:	443-875-5960
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LYDIA ELIZABETH PAVELKA
Credential	:	DPT
Telephone Number	:	443-875-5960

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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Directions to “ROOTED STRENGTH PHYSICAL THERAPY ” Practice Location

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