# LHMG PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1508373010
- **Authorized official:** PETER ODENWALD (CHEIF OPERATING OFFICER)
- **Authorized official phone:** (443) 481-6415

## Contact information

- **Practice address:** 70 CENTRAL AVE W, EDGEWATER, MD 21037-2622
- **Practice address phone:** (443) 481-1140
- **Practice address fax:** (410) 956-0600
- **Mailing address:** PO BOX 15945, BELFAST, ME 04915-4054

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 01/05/2018
- **Last updated:** 05/24/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 455625ZR1S | MEDICARE PIN | MD |