Manolo Carlos, DPT | |
75 Thomas Johnson Dr Ste M, Frederick, MD 21702-4895 | |
(301) 698-9761 | |
Not Available |
Full Name | Manolo Carlos |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 75 Thomas Johnson Dr Ste M, Frederick, Maryland |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1891003778 | NPI | - | NPPES |
19731 | Other | MD | MD LICENSE |
1063669927 | Other | MD | NPI GROUP |
263150124 | Other | MD | TAX ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 19731 (Maryland) | Primary |
Provider Name | Maryland Sportscare & Rehab Llc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1518951995 PECOS PAC ID: 2860440427 Enrollment ID: O20151113000065 |
Mailing Address | Practice Location Address |
---|---|
Manolo Carlos, DPT 2122 York Rd Ste 300, Oak Brook, IL 60523-1925 Ph: (630) 575-6200 | Manolo Carlos, DPT 75 Thomas Johnson Dr Ste M, Frederick, MD 21702-4895 Ph: (301) 698-9761 |
Pivot Physical Therapy Of Maryland Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 141 Thomas Johnson Dr, Ste 180, Frederick, MD 21702 Phone: 301-620-7478 Fax: 301-620-7479 | |
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Mr. Thomas Michael Stief, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 626 Trail Ave, Frederick, MD 21701 Phone: 301-662-1997 Fax: 301-668-2202 | |
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