MEDICARE: PHYSIOTHERAPY ASSOCIATES INC

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	:	1578640025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSIOTHERAPY ASSOCIATES INC

Provider Business Mailing Address
First Line	:	211 NORTH ST
Second Line	:
City	:	ELKTON
State	:	MD
Zip	:	21921-5512
Country	:	US
Telephone Number	:	410-620-4795
Fax Number	:	410-620-4869

Provider Business Practice Location Address
First Line	:	2076 LORD BALTIMORE DR
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21244-2501
Country	:	US
Telephone Number	:	410-944-9445
Fax Number	:	410-944-9978

Authorized Official
Title or Position	:	CONTRACTING
Name	:	ROB ZIGENFUS
Credential	:
Telephone Number	:	901-685-7227

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/09/2007

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