Provider Demographics
NPI: | 1699240556 |
---|---|
Name: | 3RD LAW PHYSICAL THERAPY, PLLC |
Entity type: | Organization |
Organization Name: | 3RD LAW PHYSICAL THERAPY, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PHYSICAL THERAPIST, OWNER |
Authorized Official - Prefix: | MISS |
Authorized Official - First Name: | MELANIE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SMITH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DPT, OCS |
Authorized Official - Phone: | 813-368-0233 |
Mailing Address - Street 1: | 1235 JACKSON ST NE |
Mailing Address - Street 2: | |
Mailing Address - City: | WASHINGTON |
Mailing Address - State: | DC |
Mailing Address - Zip Code: | 20017-4018 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1681 KALORAMA RD NW |
Practice Address - Street 2: | |
Practice Address - City: | WASHINGTON |
Practice Address - State: | DC |
Practice Address - Zip Code: | 20009-3545 |
Practice Address - Country: | US |
Practice Address - Phone: | 813-368-0233 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-10-08 |
Last Update Date: | 2018-10-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Single Specialty |