# AAA PHYSICAL THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366986762
- **Authorized official:** ROEL MANUEL EVANGELISTA (MANAGING MEMBER)
- **Authorized official phone:** (443) 979-7171

## Contact information

- **Practice address:** 6955 OAKLAND MILLS RD, STE E, COLUMBIA, MD 21045-5849
- **Practice address phone:** (443) 979-7171
- **Practice address fax:** (667) 200-5908
- **Mailing address:** 6955 OAKLAND MILLS RD, STE E, COLUMBIA, MD 21045-5849
- **Mailing address phone:** (443) 979-7171
- **Mailing address fax:** (667) 200-5908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 22980 | MD | Yes |

## Other

- **Enumeration date:** 12/05/2016
- **Last updated:** 12/05/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 228850 | MEDICARE | MD |
| 05 | — | 523804800 | — | MD |