Provider Demographics
NPI:1306447008
Name:NOL PHYSICAL THERAPY, L.L.C.
Entity type:Organization
Organization Name:NOL PHYSICAL THERAPY, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERWIN
Authorized Official - Middle Name:RODRIGUEZ
Authorized Official - Last Name:NOL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:301-861-4009
Mailing Address - Street 1:6620 CRAIN HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-4273
Mailing Address - Country:US
Mailing Address - Phone:301-861-4009
Mailing Address - Fax:301-861-4032
Practice Address - Street 1:6620 CRAIN HWY STE 101
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-4273
Practice Address - Country:US
Practice Address - Phone:301-861-4009
Practice Address - Fax:301-861-4032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-08
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty