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Organization
EVIDENCE PHYSICAL THERAPY, LLC
Active
Organization
EVIDENCE PHYSICAL THERAPY, LLC
Active
Other names
EvidencePT
Organization subpart
No
Provider details
NPI number
Authorized official
HASSANA MOSES SHRM-CP (PRACTICE ADMINISTRATOR)
(301) 352-8370
Entity
Organization
Contact information
Practice address
12150 ANNAPOLIS RD STE 201, GLENN DALE, MD 20769-9183
(301) 352-8370
(301) 352-8372
Mailing address
12150 ANNAPOLIS RD STE 201, GLENN DALE, MD 20769-9183
(301) 352-8370
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
533704600
—
MD
05
—
533704601
—
MD
01
—
616235300
DEPARTMENT OF LABOR
MD
Enumeration date
06/13/2022
Last updated
06/13/2022
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