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Organization
ORTHOPEDIC & SPORTS PHYSICAL THERAPY
Active
Organization
ORTHOPEDIC & SPORTS PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT E KANS JR. (OWNER)
(301) 645-6680
Entity
Organization
Contact information
Practice address
10665 STANHAVEN PL, SUITE 103, WHITE PLAINS, MD 20695-3060
(301) 645-6680
(301) 645-5363
Mailing address
10665 STANHAVEN PL, SUITE 103, WHITE PLAINS, MD 20695-3060
(301) 645-6680
(301) 645-5363
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19798
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1064250
AETNA
MD
01
—
2140256
UNITED HEALTHCARE
MD
01
—
60906402
CAREFIRST
MD
01
—
K7590001
CAREFIRST DC
MD
Enumeration date
04/16/2007
Last updated
03/04/2009
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