Organization
FORM AND MOTION PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INGRID PAILTHORP (OWNER AND PHYSICAL THERAPIST)
(410) 703-6097
Entity
Organization
Contact information
Practice address
304 B HARRY S. TRUMAN PARKWAY, ANNAPOLIS, MD 21401-7449
(410) 703-6097
Mailing address
304 B HARRY S. TRUMAN PARKWAY, ANNAPOLIS, MD 21401-7449
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23736
MD
Other
Enumeration date
08/26/2011
Last updated
08/26/2011
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