Provider Demographics
NPI:1053705632
Name:FIRST PHYSICAL THERAPY NETWORK, INC
Entity type:Organization
Organization Name:FIRST PHYSICAL THERAPY NETWORK, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUR
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:301-648-5406
Mailing Address - Street 1:PO BOX 151
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-0151
Mailing Address - Country:US
Mailing Address - Phone:410-662-7977
Mailing Address - Fax:410-662-4544
Practice Address - Street 1:200 W COLD SPRING LN
Practice Address - Street 2:#300
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2831
Practice Address - Country:US
Practice Address - Phone:410-662-7977
Practice Address - Fax:410-662-4544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20271225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty