MEDICARE: PERSONAL REHABILITATION SERVICES 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	225100000X	Physical Therapist	14532	MD

General Provider Information

NPI Number	:	1639134265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSONAL REHABILITATION SERVICES INC

Provider Business Mailing Address
First Line	:	9110 PHILADELPHIA RD
Second Line	:	SUITE 100
City	:	BALTIMORE
State	:	MD
Zip	:	21237-4301
Country	:	US
Telephone Number	:	410-574-4966
Fax Number	:	410-574-4968

Provider Business Practice Location Address
First Line	:	9110 PHILADELPHIA RD
Second Line	:	SUITE 100
City	:	BALTIMORE
State	:	MD
Zip	:	21237-4301
Country	:	US
Telephone Number	:	410-574-4966
Fax Number	:	410-574-4968

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JESE L B THURLOW
Credential	:	PT
Telephone Number	:	410-574-4966

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	08/22/2020

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