Provider Demographics
NPI:1194879858
Name:ATLANTIC PHYSICAL THERAPY AND REHAB CENTER LTD
Entity type:Organization
Organization Name:ATLANTIC PHYSICAL THERAPY AND REHAB CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:STURM
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:301-598-7420
Mailing Address - Street 1:13975 CONNECTICUT AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2921
Mailing Address - Country:US
Mailing Address - Phone:301-598-7420
Mailing Address - Fax:301-598-7432
Practice Address - Street 1:13975 CONNECTICUT AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2921
Practice Address - Country:US
Practice Address - Phone:301-598-7420
Practice Address - Fax:301-598-7432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7751010Medicaid
DCS986000OtherCF BLUE CROSS BLUE SHIELD
MD683203200OtherAMERIGROUP
MDLK24ATOtherCF BLUE CROSS BLUE SHIELD
MD338063OtherMAMSI LIFE MD IPA
MDG02228Medicare ID - Type UnspecifiedHOME THERAPY
MD338063OtherMAMSI LIFE MD IPA