Organization
LIFE FITNESS PHYSICAL THERAPY OF ELLICOTT CITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANNA KING (VP, AUTHORIZED OFFICIAL)
(713) 297-7000
Entity
Organization
Contact information
Practice address
9171 BALTIMORE NATIONAL PIKE, SUITE 120, ELLICOTT CITY, MD 21042-3922
(410) 480-3705
(410) 480-3707
Mailing address
9171 BALTIMORE NATIONAL PIKE, SUITE 120, ELLICOTT CITY, MD 21042-3922
(410) 480-3705
(410) 480-3707
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/05/2007
Last updated
10/02/2008
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