205 Armstrong Avenue Operations LLC

NPI #1043664428 in Centreville, Maryland

Provider Information

NPI Number: 1043664428
Entity Type: Organization
Organization Name: 205 Armstrong Avenue Operations LLC
Primary Specialty: Physical Therapist
Enumeration Date: Apr 21, 2016
Last Updated: Aug 31, 2017

Practice Location

Address: 205 ARMSTRONG ST
City: Centreville
State: Maryland
ZIP Code: 21617-2125
Phone: (410) 758-2323

Authorized Official

Name: MICHAEL T. BERG
Title: ASSISTANT SECRETARY
Phone: (505) 468-4752

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Physical Therapist	225100000X	Primary

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