Provider Demographics
NPI:1528945672
Name:PROFLEX PHYSICAL THEARPY OF MARYLAND, LLC
Entity type:Organization
Organization Name:PROFLEX PHYSICAL THEARPY OF MARYLAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING/CRED
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:HEIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-932-4785
Mailing Address - Street 1:616 GARRISONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-3707
Mailing Address - Country:US
Mailing Address - Phone:540-628-4612
Mailing Address - Fax:540-628-4615
Practice Address - Street 1:616 GARRISONVILLE RD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-3707
Practice Address - Country:US
Practice Address - Phone:540-628-4612
Practice Address - Fax:540-628-4615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation