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Organization
RESURGENT PERFORMANCE PT
Active
Organization
RESURGENT PERFORMANCE PT
Active
Other names
Resurgent Performance Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS FREDERICK VAN ORNUM DPT (OWNER/FOUNDER)
(240) 261-6136
Entity
Organization
Contact information
Practice address
16810 OAKMONT AVE, GAITHERSBURG, MD 20877-4110
(240) 261-6136
Mailing address
16810 OAKMONT AVE, GAITHERSBURG, MD 20877-4110
(240) 261-6136
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
25246
MD
Other
Enumeration date
08/26/2016
Last updated
08/26/2016
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