| Organization Name: | CHESAPEAKE PHYSICAL AQUATIC THERAPY INC |
| NPI Number: | 1124172895 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JARED STEWART GOLDSTEIN (OWNER) |
| Mailing Address: | 551f Baltimore Annapolis Blvd Severna Park |
| State: | MD US |
| Postal Code: | 211463809 |
| Phone Number: | 4103159080 |
| Fax Number: | 4103159012 |
| NPI Enumeration Date: | 01/22/2007 |
| NPI Last Update Date: | 12/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |