9101 Second Avenue Operations LLC
Physical Therapist in Silver Spring, MD. Organization (NPI-2).
NPI number1982058335
StatusActive
Last updated in NPPESSep 7, 2017
Details
- NPI
- 1982058335
- Entity type
- Organization (NPI-2)
- Legal business name
- 9101 Second Avenue 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 | 15006 | MD | Yes |
| 225X00000X | Occupational Therapist | 15006 | MD |
Other names
- Woodside Center (Doing Business As)
Practice location
9101 2nd AveSilver Spring, MD 20910-2152
Phone 301-588-5544
Mailing address
9101 2nd AveSilver Spring, MD 20910-2152
Phone 301-588-5544
Authorized official
Michael T. Berg
Assistant Secretary
5054684752
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