# OPTIMUM PHYSICAL THERAPY AND WELLNESS, LLC

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

## Provider details

- **NPI number:** 1538627492
- **Authorized official:** TIMOTHY GARRISON DPT (MANAGER/THERAPIST)
- **Authorized official phone:** (410) 726-6890

## Contact information

- **Practice address:** 1050 KEY PKWY STE 202, FREDERICK, MD 21702-4551
- **Practice address phone:** (240) 629-3944
- **Mailing address:** 134 GREENRIDGE RD, LUTHERVILLE TIMONIUM, MD 21093-6122
- **Mailing address phone:** (410) 726-6890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/08/2019
- **Last updated:** 03/28/2019