OrganizationCharlestown(<Unavail>)Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address715 Maiden Choice Ln, Baltimore, MD 21228-5999(410) 247-2340PECOS EnrollmentBased on the most recent information from CMS, provider Charlestown does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1417033259Provider TypeOrganizationFull NameCharlestownOther Name<Unavail>SubpartNoEnumeration Date10/27/2006Last Updated8/22/2020Contact InformationPractice LocationPractice Address715 Maiden Choice Ln, Baltimore, MD 21228-5999Phone(410) 247-2340FaxUnlisted FaxMailing LocationMailing Address715 Maiden Choice Ln, Baltimore, MD 21228-5999Phone(410) 247-2340FaxUnlisted FaxAuthorized OfficialNameWagner, Mary (Director)Phone(410) 600-2334Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted Issuer