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Organization
9101 SECOND AVENUE OPERATIONS LLC
Active
Organization
9101 SECOND AVENUE OPERATIONS LLC
Active
Other names
Woodside Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
9101 2ND AVE, SILVER SPRING, MD 20910-2152
(301) 588-5544
Mailing address
9101 2ND AVE, SILVER SPRING, MD 20910-2152
(301) 588-5544
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15006
MD
225X00000X
Occupational Therapist
15006
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
443333500
—
MD
Enumeration date
04/21/2016
Last updated
09/07/2017
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