Deidre C Verlinden, PT

Individual provider Active NPI Physical Therapist · Frederick, MD

NPI 1255707691 · NPPES record last updated Sep 26, 2022

Key facts

NPI
1255707691
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070021723 (IL)
Practice address
163 Thomas Johnson Dr
Frederick, MD 21702-4673
Phone
(240) 566-3132
NPI assigned
Aug 20, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
070021723ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Active Life & Sports Therapy LLC Physical Therapist Current
since Aug 19, 2020
Accepting new patients

Locations

4337 Ebenezer Rd
Nottingham, MD 21236
Phone (410) 529-3003

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070021723 IL Yes

Addresses

Primary practice location

163 Thomas Johnson Dr
Frederick, MD 21702-4673

Mailing address

163 Thomas Johnson Dr
Frederick, MD 21702-4673

Other providers in Frederick, MD

All providers in Frederick, MD · Physical Therapist in Maryland

Sources for this page

Verify at the official NPI Registry.