# ACTIVE PHYSICAL THERAPY SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043892797
- **Authorized official:** TERRY PAUL (CREDENTIAL COORDINATOR)
- **Authorized official phone:** (410) 970-8190

## Contact information

- **Practice address:** 405 S JEFFERSON ST UNIT B, FREDERICK, MD 21701-6272
- **Practice address phone:** (301) 662-9335
- **Mailing address:** PO BOX 419666, BOSTON, MA 02241-0966
- **Mailing address phone:** (410) 970-8190

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/22/2021
- **Last updated:** 04/22/2021