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NPI Code Detail

MEDICARE: CHARLES SCLATER PHYSICAL THERAPY LLC

MEDICARE: CHARLES SCLATER 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
1225100000XPhysical Therapist20886MD

General Provider Information

NPI Number : 1841569803
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARLES SCLATER PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : 8501 BAYSIDE RD
Second Line : UNIT C4
City : CHESAPEAKE BEACH
State : MD
Zip : 20732-3313
Country : US
Telephone Number : 443-964-5656
Fax Number : 443-964-5657
Provider Business Practice Location Address
First Line : 8501 BAYSIDE RD
Second Line : UNIT C4
City : CHESAPEAKE BEACH
State : MD
Zip : 20732-3350
Country : US
Telephone Number : 443-964-5656
Fax Number : 443-964-5657
Authorized Official
Title or Position : OWNER/DIRECTOR
Name : CHARLES SCLATER
Credential : MS PT
Telephone Number : 443-964-5656
Provider Enumeration Date : 12/21/2011
Last Update Date : 02/27/2012

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Directions to “CHARLES SCLATER PHYSICAL THERAPY LLC ” Practice Location

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