# EVOLUTION PHYSICAL THERAPY LLC

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

## Provider details

- **NPI number:** 1588208243
- **Authorized official:** KENNETH LOU DPT (OWNER)
- **Authorized official phone:** (301) 861-2388

## Contact information

- **Practice address:** 23207 STRINGTOWN RD, CLARKSBURG, MD 20871-9363
- **Practice address phone:** (301) 861-2388
- **Practice address fax:** (240) 454-0159
- **Mailing address:** 23207 STRINGTOWN RD, CLARKSBURG, MD 20871-9363
- **Mailing address phone:** (301) 861-2388
- **Mailing address fax:** (240) 454-0159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 11/05/2019
- **Last updated:** 01/12/2024