Organization
CPT, LLC
Active
Other names
POTOMAC BEHAVIORAL AND OCCUPATIONAL THERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY KENNELL (CREDENTIALING MANAGER)
(301) 722-0616
Entity
Organization
Contact information
Practice address
249 HENDERSON AVE, CUMBERLAND, MD 21502-1638
(240) 362-7444
(240) 362-7388
Mailing address
249 HENDERSON AVE, CUMBERLAND, MD 21502-1638
(240) 362-7444
(240) 362-7388
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/16/2017
Last updated
02/16/2017
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