# PRESTIGE PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1912140112
- **Authorized official:** MR. RICHARD E DIXON JR. PT (OWNER)
- **Authorized official phone:** (301) 829-6770

## Contact information

- **Practice address:** 186 THOMAS JOHNSON DR STE 105, FREDERICK, MD 21702-4315
- **Practice address phone:** (301) 829-6770
- **Practice address fax:** (301) 829-6610
- **Mailing address:** 23202 BREWERS TAVERN WAY, CLARKSBURG, MD 20871-4391
- **Mailing address phone:** (301) 829-6770
- **Mailing address fax:** (301) 829-6610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 140233 | MD | Yes |

## Other

- **Enumeration date:** 04/17/2009
- **Last updated:** 04/17/2009