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Organization
PROACTIVE THERAPY, LLC
Active
Organization
PROACTIVE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRELL D. TRENT OT (OWNER)
(202) 409-9895
Entity
Organization
Contact information
Practice address
1016 BOOTH ST, BALTIMORE, MD 21223-2527
(202) 409-9895
(202) 470-0423
Mailing address
1016 BOOTH ST, BALTIMORE, MD 21223-2527
(202) 409-9895
(202) 470-0423
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17825
MD
225X00000X
Occupational Therapist
04737
MD
Other
Enumeration date
07/07/2006
Last updated
05/11/2022
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