# PHYSICAL THERAPY AND PAIN MANAGEMENT CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PHYSICAL THERAPY AND PAIN MANAGEMENT CENTER LLC
- **Other names:** College Park Physical Therapy & Hand Rehabilitation
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1982337424
- **Legal business name:** PHYSICAL THERAPY AND PAIN MANAGEMENT CENTER LLC
- **Authorized official:** MR. DAVID MICHAEL BULLOCK P.T. (FOUNDER)
- **Authorized official phone:** (301) 592-8200

## Contact information

- **Practice address:** 4595 VAN BUREN ST STE 210, RIVERDALE PARK, MD 20737-1080
- **Practice address phone:** (301) 864-0009
- **Practice address fax:** (301) 864-0012
- **Mailing address:** 4595 VAN BUREN ST STE 210, RIVERDALE PARK, MD 20737-1080
- **Mailing address phone:** (301) 864-0009
- **Mailing address fax:** (301) 864-0012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 07/01/2022
- **Last updated:** 01/30/2023