Organization Name: | KAYMON PHYSICAL THERAPY AND ASSOCIATES |
NPI Number: | 1669833661 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EARLENE D. JACKSON (PRESIDENT/ CEO) |
Mailing Address: | 9201 Edgeworth Dr #4251 Capitol Heights |
State: | MD US |
Postal Code: | 207917501 |
Phone Number: | 2402450476 |
Fax Number: | 2022045637 |
NPI Enumeration Date: | 03/18/2016 |
NPI Last Update Date: | 04/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 23062 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |