Organization
FUNCTIONAL PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIELA VAN SICKLE PT, DPT, CMFT (OWNER/PHYSICAL THERAPIST)
(301) 602-3117
Entity
Organization
Contact information
Practice address
103 N ADAMS ST STE 1-2, ROCKVILLE, MD 20850-2256
(301) 602-3117
Mailing address
7509 OLD CHAPEL DR, BOWIE, MD 20715-6011
(301) 602-3117
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
26474
MD
Other
Enumeration date
08/10/2017
Last updated
08/10/2017
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