| Sports Pro Physical Therapy South Llc | |
|
930 E Swan Creek Rd, Fort Washington, MD 20744-5250 | |
| (301) 805-5006 | |
| (301) 805-5004 |
| Full Name | Sports Pro Physical Therapy South Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 930 E Swan Creek Rd, Fort Washington, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124438700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 18090 (Maryland) | Primary |
| Provider Name | Daryl Andrew Clarke |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689709719 PECOS PAC ID: 2163596677 Enrollment ID: I20080801000060 |
| Provider Name | Tamara E Johnson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174700413 PECOS PAC ID: 1052552247 Enrollment ID: I20130731000281 |
| Provider Name | Angela R. Richards |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205891595 PECOS PAC ID: 5496803306 Enrollment ID: I20130815000064 |
| Provider Name | Mridula Kaimal |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639683675 PECOS PAC ID: 1355601931 Enrollment ID: I20180130000220 |
| Provider Name | Toshita Hemant Ambegaonkar |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386204782 PECOS PAC ID: 9133551088 Enrollment ID: I20191114000031 |
| Mailing Address | Practice Location Address |
|---|---|
| Sports Pro Physical Therapy South Llc 930 E Swan Creek Rd, Fort Washington, MD 20744-5250 Ph: (301) 805-5006 | Sports Pro Physical Therapy South Llc 930 E Swan Creek Rd, Fort Washington, MD 20744-5250 Ph: (301) 805-5006 |
Mia A Countiss, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 11701 Livingston Rd Ste 202, Fort Washington, MD 20744 Phone: 110-456-2537 | |
Dr. Oluwaseyi Ogunye, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 10905 Fort Washington Rd, Fort Washington, MD 20744 Phone: 301-292-5100 Fax: 301-292-2847 | |
Wyndetta Valentine Taylor, PHYSICAL THERAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 13235 Old Fort Rd, Fort Washington, MD 20744 Phone: 301-257-2111 | |
Joshua Earl Todd, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 10905 Fort Washington Rd Ste 101, Fort Washington, MD 20744 Phone: 301-292-5100 | |
Fnu Sindhuja Gunasekaran, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 11701 Livingston Rd Ste 202, Fort Washington, MD 20744 Phone: 443-512-8337 Fax: 443-327-5282 | |
Vishnupriya Ramasamy, Physical Therapist Medicare: Medicare Enrolled Practice Location: 12021 Livingston Rd, Fort Washington, MD 20744 Phone: 301-292-0300 |