| Proactive Therapy, Llc | |
|
1016 Booth St, Baltimore, MD 21223-2527 | |
| (202) 409-9895 | |
| (202) 470-0423 |
| Full Name | Proactive Therapy, Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 1016 Booth St, Baltimore, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023040128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 17825 (Maryland) | Primary |
| 225X00000X | Occupational Therapist | 04737 (Maryland) | Secondary |
| Provider Name | Terrell D Trent |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992898407 PECOS PAC ID: 5193611275 Enrollment ID: I20040225000775 |
| Provider Name | Jay W Neal |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1396769329 PECOS PAC ID: 3476449547 Enrollment ID: I20040225001013 |
| Provider Name | Carmen Tucker-richardson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1801915079 PECOS PAC ID: 0749417822 Enrollment ID: I20131217000497 |
| Provider Name | Olugbolahan J Anifowose |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740715168 PECOS PAC ID: 7214200492 Enrollment ID: I20170911000827 |
| Provider Name | Adaobi E Igboanugo |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720569171 PECOS PAC ID: 8325370547 Enrollment ID: I20191021002593 |
| Provider Name | Asia T Blackwell |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1477079929 PECOS PAC ID: 0345653242 Enrollment ID: I20210114001662 |
| Provider Name | Summer J Tysor |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477134740 PECOS PAC ID: 2062820574 Enrollment ID: I20210422001201 |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Therapy, Llc 1016 Booth St, Baltimore, MD 21223-2527 Ph: (202) 409-9895 | Proactive Therapy, Llc 1016 Booth St, Baltimore, MD 21223-2527 Ph: (202) 409-9895 |
Liberty Medical &injury Center Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7034 Liberty Rd, Baltimore, MD 21207 Phone: 410-580-9191 | |
Ms. Susan Kay Dubroff, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1708 W Rogers Ave, Baltimore, MD 21209 Phone: 410-578-5224 | |
Rhonda G Stallings, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 707 N Broadway, Kennedy Krieger Institute, Baltimore, MD 21205 Phone: 443-923-9200 Fax: 443-923-9405 | |
Kimberly Ann Cardosa, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2200 Kernan Dr, Baltimore, MD 21207 Phone: 410-448-6323 Fax: 410-448-6338 | |
Joanne Gamble, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 5731 Cottonworth Ave, Baltimore, MD 21209 Phone: 410-708-4763 | |
Evangeline Lajom Grecia, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 200 E North Ave, Baltimore, MD 21202 Phone: 443-642-4208 | |
Steven G Peters, Physical Therapist Medicare: Medicare Enrolled Practice Location: 1420 Clarkview Rd, Baltimore, MD 21209 Phone: 443-213-0395 |