Organization
VITAL SELF PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN H COLLINS MPT, CLT-LANA (PHYSICAL THERAPIST)
(313) 550-6367
Entity
Organization
Contact information
Practice address
7610 PENNSYLVANIA AVE, FORESTVILLE, MD 20747-4701
(313) 550-6367
(301) 669-1873
Mailing address
7610 PENNSYLVANIA AVE, FORESTVILLE, MD 20747-4701
(313) 550-6367
(301) 669-1873
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
24460
MD
Other
Enumeration date
05/18/2013
Last updated
06/18/2013
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