Organization
FORM & FUNCTION PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN ANDERSON MPT (PRESIDENT)
(301) 967-1215
Entity
Organization
Contact information
Practice address
5924 MARLBORO PIKE, DISTRICT HEIGHTS, MD 20747-1142
(202) 316-3658
(301) 967-1215
Mailing address
5924 MARLBORO PIKE, DISTRICT HEIGHTS, MD 20747-1142
(301) 967-1215
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
20814
MD
Other
Enumeration date
04/12/2007
Last updated
05/27/2011
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