Organization
PHYSICAL THERAPY AND PAIN MANAGEMENT CENTER LLC
Active
Other names
White Oak Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID MICHAEL BULLOCK P.T. (FOUNDER)
(301) 592-8200
Entity
Organization
Contact information
Practice address
11120 NEW HAMPSHIRE AVE, SUITE 200, SILVER SPRING, MD 20904-2633
(301) 592-8200
(301) 592-8300
Mailing address
11120 NEW HAMPSHIRE AVE, SUITE 200, SILVER SPRING, MD 20904-2633
(301) 592-8200
(301) 592-8300
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
21045
MD
261QR0400X
Rehabilitation Clinic/Center
870427
DC
261QR0400X
Rehabilitation Clinic/Center
PT870409
DC
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
413765500
—
MD
Enumeration date
04/09/2007
Last updated
01/17/2024
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