| Doctor Name: | LEVI D CUSTIS |
| NPI Number: | 1528483054 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | J1-0003143 |
| Business Practice Address: | 11070 Cathell Rd Unit 4 Berlin, MD - 218119344 |
| Business Phone Number: | 4102083630 |
| Business Fax Number: | 4102083632 |
| Mailing Address: | 408 Camden Ave, SALISBURY |
| State: | MD |
| Postal Code: | 218015304 |
| Phone Number: | 4102083630 |
| Fax Number: | 4102083632 |
| NPI Enumeration Date: | 02/20/2014 |
| NPI Last Update Date: | 02/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | J1-0003143 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | DE |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |