Provider Demographics
NPI:1548539406
Name:ABSOLUTE PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:ABSOLUTE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:240-419-5101
Mailing Address - Street 1:3200 CRAIN HWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4841
Mailing Address - Country:US
Mailing Address - Phone:240-419-5101
Mailing Address - Fax:240-419-5106
Practice Address - Street 1:3200 CRAIN HWY
Practice Address - Street 2:SUITE 103
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4841
Practice Address - Country:US
Practice Address - Phone:240-419-5101
Practice Address - Fax:240-419-5106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty