Organization
EVIDENCE PHYSICAL THERAPY, LLC
Active
Other names
EvidencePT
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HASSANA MOSES SHRM-CP (PRACTICE ADMINISTRATOR)
(301) 352-8370
Entity
Organization
Contact information
Practice address
12150 ANNAPOLIS RD STE 201, GLENN DALE, MD 20769
(301) 352-8370
(301) 352-8372
Mailing address
12150 ANNAPOLIS RD, SUITE 201, GLENN DALE, MD 20769-9183
(301) 352-8370
(301) 352-8372
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
21846
MD
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045308100
—
MD
01
—
616235300
WORKERS COMPENSATION NUMBER
—
Enumeration date
01/03/2011
Last updated
12/05/2024
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