Provider Demographics
NPI:1144292863
Name:KOTZ, PETER J (ATC)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:J
Last Name:KOTZ
Suffix:
Gender:M
Credentials:ATC
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Mailing Address - Street 1:5468 WOODED WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-5722
Mailing Address - Country:US
Mailing Address - Phone:410-964-0861
Mailing Address - Fax:
Practice Address - Street 1:11601 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-1916
Practice Address - Country:US
Practice Address - Phone:301-942-1155
Practice Address - Fax:301-942-2555
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer