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Organization
GO STRETCH
Active
Organization
GO STRETCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKIELA RE' NELSON DPT (DOCTOR OF PHYSICAL THERAPY)
(301) 785-1025
Entity
Organization
Contact information
Practice address
9698 MARLBORO PIKE, UPPER MARLBORO, MD 20772-3767
(301) 278-7353
Mailing address
9698 MARLBORO PIKE, UPPER MARLBORO, MD 20772-3767
(301) 278-7353
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225400000X
Rehabilitation Practitioner
Primary
—
NULL
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
08/03/2020
Last updated
03/20/2025
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