Organization
EVOLUTION PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH LOU DPT (OWNER)
(301) 861-2388
Entity
Organization
Contact information
Practice address
23207 STRINGTOWN RD, CLARKSBURG, MD 20871-9363
(301) 861-2388
(240) 454-0159
Mailing address
23207 STRINGTOWN RD, CLARKSBURG, MD 20871-9363
(301) 861-2388
(240) 454-0159
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
11/05/2019
Last updated
01/12/2024
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