| Organization Name: | FREE STATE PHYSICAL THERAPY, LLC |
| NPI Number: | 1376986851 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHIRLIE B PERRONE (OWNER/PHYSICAL THERAPIST) |
| Mailing Address: | 314 German Hill Rd Dundalk |
| State: | MD US |
| Postal Code: | 212221527 |
| Phone Number: | 4102881170 |
| Fax Number: | 4102881172 |
| NPI Enumeration Date: | 04/15/2013 |
| NPI Last Update Date: | 04/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 20375 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |