MEDICARE: CARE PLUS 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	22412	MD

General Provider Information

NPI Number	:	1295013456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE PLUS PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	9123 GAITHER RD
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20877-1451
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9123 GAITHER RD
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20877-1451
Country	:	US
Telephone Number	:	703-342-2612
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KYUNG HAN KIM
Credential	:	PT
Telephone Number	:	703-342-2612

Provider Enumeration Date	:	07/21/2011
Last Update Date	:	10/10/2011

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