# EVIDENCE PHYSICAL THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EVIDENCE PHYSICAL THERAPY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1982176988
- **Legal business name:** EVIDENCE PHYSICAL THERAPY
- **Authorized official:** HASSANA MOSES (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (301) 352-8370

## Contact information

- **Practice address:** 7801 OLD BRANCH AVE STE 105, CLINTON, MD 20735-1641
- **Practice address phone:** (301) 856-8386
- **Mailing address:** 12150 ANNAPOLIS RD STE 201, GLENN DALE, MD 20769-9183
- **Mailing address phone:** (301) 352-8370
- **Mailing address fax:** (301) 352-8372

## Taxonomy

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

## Other

- **Enumeration date:** 01/02/2019
- **Last updated:** 01/02/2019