Provider Demographics
NPI:1215434493
Name:A1 PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:A1 PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-703-1082
Mailing Address - Street 1:808 TOLL HOUSE AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4519
Mailing Address - Country:US
Mailing Address - Phone:240-446-6616
Mailing Address - Fax:
Practice Address - Street 1:8055 RITCHIE HWY STE 105
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-1074
Practice Address - Country:US
Practice Address - Phone:240-446-6616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty