Provider Demographics
NPI:1124483243
Name:ACL PHYSICAL THERAPY AND REHABILITATION INC
Entity type:Organization
Organization Name:ACL PHYSICAL THERAPY AND REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LAZARO
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:410-603-9237
Mailing Address - Street 1:701 E NAYLOR MILL RD UNIT F
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-2308
Mailing Address - Country:US
Mailing Address - Phone:757-710-2240
Mailing Address - Fax:443-210-2473
Practice Address - Street 1:701 E NAYLOR MILL RD UNIT F
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-2308
Practice Address - Country:US
Practice Address - Phone:443-944-0037
Practice Address - Fax:443-210-2473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty