# PREMISE HEALTH OF MARYLAND MEDICAL P C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AZ Employee Health and Wellness Center Gaithersburg Physical Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235942467
- **Authorized official:** JONATHAN B LEIZMAN (PRESIDENT)
- **Authorized official phone:** (216) 479-9063

## Contact information

- **Practice address:** 101 ORCHARD RIDGE DR, GAITHERSBURG, MD 20878-1917
- **Practice address phone:** (301) 398-6893
- **Practice address fax:** (301) 398-6893
- **Mailing address:** 5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
- **Mailing address phone:** (301) 398-6893
- **Mailing address fax:** (301) 398-6893

## Taxonomy

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

## Other

- **Enumeration date:** 01/30/2025
- **Last updated:** 01/30/2025