# DRAYER PHYSCIAL THERAPY OF MARYLAND, LLC

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

## Provider details

- **NPI number:** 1750792958
- **Authorized official:** LISA BENETTO (MANAGER OF PAYOR & PROV ENROLLMENT)
- **Authorized official phone:** (423) 238-8923

## Contact information

- **Practice address:** 7850 ROSSVILLE BLVD STE 206-208, BALTIMORE, MD 21236-3934
- **Practice address phone:** (410) 931-2738
- **Practice address fax:** (410) 931-2739
- **Mailing address:** 8205 PRESIDENTS DR FL 2, HUMMELSTOWN, PA 17036-8621
- **Mailing address phone:** (717) 839-2159
- **Mailing address fax:** (717) 565-1104

## Taxonomy

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

## Other

- **Enumeration date:** 05/12/2014
- **Last updated:** 02/12/2020
