MEDICARE: VIRTUAL HEALTH 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

General Provider Information

NPI Number	:	1316532948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRTUAL HEALTH PT

Provider Business Mailing Address
First Line	:	3746 GREENWAY LN
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-1418
Country	:	US
Telephone Number	:	443-956-8608
Fax Number	:

Provider Business Practice Location Address
First Line	:	3746 GREENWAY LN
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-1418
Country	:	US
Telephone Number	:	443-956-8608
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JARED GOLDSTEIN
Credential	:
Telephone Number	:	443-956-8608

Provider Enumeration Date	:	03/05/2021
Last Update Date	:	03/05/2021

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Directions to “VIRTUAL HEALTH PT ” Practice Location

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