Provider Demographics
NPI:1407747199
Name:LEAR, AUSTIN M (DPT, CSCS)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:M
Last Name:LEAR
Suffix:
Gender:M
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 SCRAVEL RD
Mailing Address - Street 2:
Mailing Address - City:MYERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21773-9202
Mailing Address - Country:US
Mailing Address - Phone:301-401-3038
Mailing Address - Fax:
Practice Address - Street 1:7311 GROVE RD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-5146
Practice Address - Country:US
Practice Address - Phone:240-608-6031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30485225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist