Organization
JESSE L B THURLOW PT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSE L B THURLOW PT (OWNER)
(410) 574-4966
Entity
Organization
Contact information
Practice address
9110 PHILADELPHIA RD, SUITE 100, ROSEDALE, MD 21237-4323
(410) 574-4966
(410) 574-4968
Mailing address
9110 PHILADELPHIA RD, SUITE 100, ROSEDALE, MD 21237-4323
(410) 574-4966
(410) 574-4968
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14532
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42191502
BCBS MD
MD
01
—
D481473
AETNA
MD
Enumeration date
10/04/2006
Last updated
08/22/2020
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