Southern Maryland Myofascial Release, Inc.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

20414 Issued in MD

Legal business name

SOUTHERN MARYLAND MYOFASCIAL RELEASE, INC.

Practice address

90 Holiday Drive
Suite C and D1
Solomons, MD 20688

Phone

(410) 449-6682

Fax

(410) 449-6684

NPI assigned

Dec 19, 2016

Last updated

Dec 19, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Heather Allen, PT

Title

President/Physical Therapist

Phone

(410) 449-6682

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482105600000",
    "number": "1770027260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12699 CHEYENNE TRL",
            "city": "LUSBY",
            "state": "MD",
            "postal_code": "206574512",
            "telephone_number": "410-449-6682",
            "fax_number": "410-449-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 HOLIDAY DRIVE",
            "address_2": "SUITE C AND D1",
            "city": "SOLOMONS",
            "state": "MD",
            "postal_code": "20688",
            "telephone_number": "410-449-6682",
            "fax_number": "410-449-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MARYLAND MYOFASCIAL RELEASE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-19",
        "last_updated": "2016-12-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "410-449-6682",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MD",
            "license": "20414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopedic Physical Therapist in Solomons, MD
• Providers in Solomons, MD by specialty
• Orthopedic Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.