| Organization Name: | ERGO OCCMED, LLC |
| NPI Number: | 1720312903 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | OLU P EZEANI (CFO/ OWNER) |
| Mailing Address: | 6196 Oxon Hill Rd Suite 120 Oxon Hill |
| State: | MD US |
| Postal Code: | 207453100 |
| Phone Number: | 3015676400 |
| Fax Number: | 2023188174 |
| NPI Enumeration Date: | 09/22/2009 |
| NPI Last Update Date: | 03/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 19226 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| 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 |