Organization Name: | PHYSIOCARE REHAB & WELLNESS, LLC |
NPI Number: | 1730564394 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL ADU (OWNER) |
Mailing Address: | 7651 Matapeake Business Dr Ste 203 Brandywine |
State: | MD US |
Postal Code: | 206133038 |
Phone Number: | 4435834180 |
Fax Number: | |
NPI Enumeration Date: | 07/24/2015 |
NPI Last Update Date: | 11/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 22667 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |