Provider Demographics
NPI:1841534468
Name:VARSITY PROFESSIONAL REHABILITATION AND STAFFING, LLC
Entity type:Organization
Organization Name:VARSITY PROFESSIONAL REHABILITATION AND STAFFING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:OSEI
Authorized Official - Last Name:MERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:202-277-7887
Mailing Address - Street 1:PO BOX 1597
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20013-1597
Mailing Address - Country:US
Mailing Address - Phone:202-277-7887
Mailing Address - Fax:240-419-3090
Practice Address - Street 1:14000 JERICHO PARK ROAD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715
Practice Address - Country:US
Practice Address - Phone:202-277-7887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty