Organization
LHMG PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER ODENWALD (CHEIF OPERATING OFFICER)
(443) 481-6415
Entity
Organization
Contact information
Practice address
70 CENTRAL AVE W, EDGEWATER, MD 21037-2622
(443) 481-1140
(410) 956-0600
Mailing address
PO BOX 15945, BELFAST, ME 04915-4054
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
455625ZR1S
MEDICARE PIN
MD
Enumeration date
01/05/2018
Last updated
05/24/2021
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