Organization
PRESTIGE PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD E DIXON JR. PT (OWNER)
(301) 829-6770
Entity
Organization
Contact information
Practice address
186 THOMAS JOHNSON DR STE 105, FREDERICK, MD 21702-4315
(301) 829-6770
(301) 829-6610
Mailing address
23202 BREWERS TAVERN WAY, CLARKSBURG, MD 20871-4391
(301) 829-6770
(301) 829-6610
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
140233
MD
Other
Enumeration date
04/17/2009
Last updated
04/17/2009
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