OrganizationChesapeake Physical Aquatic Therapy IncPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address730 Frederick Rd, Catonsville, MD 21228-4532(410) 719-8661(301) 498-2212PECOS EnrollmentBased on the most recent information from CMS, provider Chesapeake Physical Aquatic Therapy Inc 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 ID1730233479Provider TypeOrganizationFull NameChesapeake Physical Aquatic Therapy IncSubpartNoEnumeration Date1/22/2007Last Updated12/19/2008Contact InformationPractice LocationPractice Address730 Frederick Rd, Catonsville, MD 21228-4532Phone(410) 719-8661Fax(410) 719-8996Mailing LocationMailing Address314 Marshall Ave, Laurel, MD 20707-4823Phone(301) 498-2212Fax(301) 498-2213Authorized OfficialNameGoldstein, Jared Stewart (Owner)Phone(410) 381-7000Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerCode2251X0800XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerIDKBX3DescriptionOtherIssuerBLUE SHIELD MDMaryland