| Form & Function Physical Therapy Llc | |
|
5924 Marlboro Pike, District Heights, MD 20747-1142 | |
| (202) 316-3658 | |
| (301) 967-1215 |
| Full Name | Form & Function Physical Therapy Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 5924 Marlboro Pike, District Heights, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508080219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 20814 (Maryland) | Primary |
| Provider Name | Kevin A Anderson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225248693 PECOS PAC ID: 7517144306 Enrollment ID: I20110603000160 |
| Mailing Address | Practice Location Address |
|---|---|
| Form & Function Physical Therapy Llc 5924 Marlboro Pike, District Heights, MD 20747-1142 Ph: () - | Form & Function Physical Therapy Llc 5924 Marlboro Pike, District Heights, MD 20747-1142 Ph: (202) 316-3658 |
Kevin A Anderson, MPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 5924 Marlboro Pike, District Heights, MD 20747 Phone: 301-967-1215 | |
Kemal Ambakisye, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5416 Silver Hill Rd, District Heights, MD 20747 Phone: 301-420-3249 | |
Dr. Jamar Domonic Smith, D.P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 2810 Walters Lane Suite 100, District Heights, MD 20747 Phone: 301-965-0348 Fax: 202-318-8492 |