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Organization
SHORTER PHYSICAL THERAPY PC
Active
Organization
SHORTER PHYSICAL THERAPY PC
Active
Other names
Excel Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA ANN SHORTER M.S., PT (OWNER)
(301) 860-0237
Entity
Organization
Contact information
Practice address
3140 W WARD RD STE 203, DUNKIRK, MD 20754-3047
(410) 286-7205
(410) 286-7206
Mailing address
PO BOX 160, FRIENDSHIP, MD 20758-0160
(310) 860-0237
(301) 860-0076
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
20258
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7094369
AETNA GROUP#
MD
01
—
KCB9EX
BLUE CROSS GROUP# MD SIDE
MD
01
—
S109
BLUE CROSS GROUP # FOR DC
MD
Enumeration date
04/24/2007
Last updated
06/28/2021
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