MEDICARE: GML PHYSICAL THERAPY LLC

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		MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S272	OTHER	MD	CARE FIRST HMO
2	2660198	OTHER	MD	AETNA HMO
3	LX64GM	OTHER	MD	CAERFIRST BC/BS
4	7506321	OTHER	MD	AETNA PPO

General Provider Information

NPI Number	:	1255415436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GML PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	2217 COMMERCE RD
Second Line	:
City	:	FOREST HILL
State	:	MD
Zip	:	21050-2565
Country	:	US
Telephone Number	:	410-638-0700
Fax Number	:	410-638-6790

Provider Business Practice Location Address
First Line	:	2217 COMMERCE RD
Second Line	:
City	:	FOREST HILL
State	:	MD
Zip	:	21050-2565
Country	:	US
Telephone Number	:	410-638-0700
Fax Number	:	410-638-6790

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	MR. DENNIS J COADY
Credential	:
Telephone Number	:	410-638-0700

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	08/22/2020

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Directions to “GML PHYSICAL THERAPY LLC ” Practice Location

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