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Organization

STRUCTURAL ELEMENTS, LLC

Active
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Organization

STRUCTURAL ELEMENTS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DOUGLAS E BERTRAM L.AC (OWNER)
(301) 766-9293
Entity
Organization

Contact information

Practice address
13214 FOUNTAINHEAD PLAZA, HAGERSTOWN, MD 21742
(301) 766-9293
Mailing address
13214 FOUNTAINHEAD PLAZA, HAGERSTOWN, MD 21742
(301) 766-9293

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
U02058
MD
225100000X
Physical Therapist
Primary
23476
MD
225100000X
Physical Therapist
24958
MD
225700000X
Massage Therapist
M05356
MD
225700000X
Massage Therapist
M05395
MD

Other

Enumeration date
11/05/2015
Last updated
11/05/2015
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