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Organization
ACTIVE PHYSICAL THERAPY SERVICES, LLC
Active
Organization
ACTIVE PHYSICAL THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS BRAY (DIRECTOR)
(703) 239-2310
Entity
Organization
Contact information
Practice address
14405 LAUREL PL, STE 102, LAUREL, MD 20707-6102
(301) 498-1604
(301) 498-1608
Mailing address
PO BOX 419666, BOSTON, MA 02241-9666
(410) 970-8190
(410) 313-8314
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8825
CAREFIRST BCBS
MD
Enumeration date
10/25/2007
Last updated
09/27/2022
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