Aquafit Physical Therapy, LLC

Organization Active NPI Physical Therapist · Odenton, MD

NPI 1386979995 · NPPES record last updated Oct 15, 2009

Key facts

NPI
1386979995
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
License
19302 (MD)
Legal business name
AQUAFIT PHYSICAL THERAPY, LLC
Practice address
8743 Piney Orchard Pkwy
Suite 105
Odenton, MD 21113-2343
Phone
(410) 598-0603
NPI assigned
Oct 15, 2009
Organization subpart
No

Authorized official

Name
Ralph Truitt, P.T.
Title
Owner
Phone
(410) 598-0603

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20091222000576 MD Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3577603505 Receives reassigned benefits from 3 practitioners
Practice locations: Odenton, MD

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X 19302 MD Yes

Addresses

Primary practice location

8743 Piney Orchard Pkwy
Suite 105
Odenton, MD 21113-2343

Mailing address

2208 Crest Rd
Baltimore, MD 21209-4207
Phone (410) 598-0603

Other providers in Odenton, MD

All providers in Odenton, MD · Physical Therapist in Maryland

Sources for this page

Verify at the official NPI Registry.