9701 Medical Center Drive Operations LLC
Physical Therapist in Rockville, MD. Organization (NPI-2).
NPI number1083068456
StatusActive
Last updated in NPPESSep 7, 2017
Details
- NPI
- 1083068456
- Entity type
- Organization (NPI-2)
- Legal business name
- 9701 Medical Center Drive Operations LLC
- Organization subpart
- No
- Enumeration date
- Apr 21, 2016
- Last updated
- Sep 7, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 15009 | MD | Yes |
| 225X00000X | Occupational Therapist | 15009 | MD |
Other names
- Shady Grove Center (Doing Business As)
Practice location
9701 Medical Center DrRockville, MD 20850-3326
Phone 301-315-1900
Mailing address
9701 Medical Center DrRockville, MD 20850-3326
Phone 301-315-1900
Authorized official
Michael T. Berg
Assistant Secretary
5054684752
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