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Organization
ASBURY ATLANTIC, INC
Active
Organization
ASBURY ATLANTIC, INC
Active
Other names
Asbury Methodist Village
Organization subpart
No
Provider details
NPI number
Authorized official
MAGDALENE OLSEN (LEGAL & COMPLIANCE PROGRAM COORD.)
(301) 250-2105
Entity
Organization
Contact information
Practice address
301 RUSSELL AVE, GAITHERSBURG, MD 20877-2807
(301) 250-2105
Mailing address
5285 WESTVIEW DR STE 200, FREDERICK, MD 21703-8521
(301) 250-2105
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
790008200
—
MD
Enumeration date
10/12/2022
Last updated
10/12/2022
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