Provider Demographics
NPI:1053868927
Name:PROFLEX PHYSICAL THERAPY OF MARYLAND, LLC
Entity type:Organization
Organization Name:PROFLEX PHYSICAL THERAPY OF MARYLAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-932-4785
Mailing Address - Street 1:PO BOX 791217
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-1217
Mailing Address - Country:US
Mailing Address - Phone:301-932-4786
Mailing Address - Fax:301-932-4789
Practice Address - Street 1:7905 MALCOLM RD
Practice Address - Street 2:201
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1734
Practice Address - Country:US
Practice Address - Phone:301-856-0050
Practice Address - Fax:301-856-0518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation