Glascow P Tennille Jr. (NPI# 1396092375, PAC ID# 6406008036) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1396092375 |
| PAC ID by PECOS | 6406008036 |
| Professional Enrollment ID | I20121206000201 |
| Full Name | Glascow P Tennille Jr. |
| Organization Legal Name | ACTIVE LIFE AND SPORTS THERAPY LLC |
| Address |
4337 Ebenezer Rd Nottingham MD 21236-2143 |
| Phone Number | 4105293303 |
| Gender | M |
| Graduation Year | 2007 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 5193711927 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 4337 Ebenezer Rd, Nottingham, MD 21236-2143 | 4105293303 | ACTIVE LIFE AND SPORTS THERAPY LLC |
| Organization Legal Name | ACTIVE LIFE AND SPORTS THERAPY LLC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brooke N Janicky | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Courtney R Ferreira | Registered Dietitian Or Nutrition Professional | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Michael Foley | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Jordan C Altekruse | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Ian Lawrence Sikora | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Michael D Wah | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Ellen M Hangen | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Michael T Smith | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Alexandra A Zeno | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Street Address |
4337 EBENEZER RD |
| City | NOTTINGHAM |
| State | MD |
| Zip | 21236-2143 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brooke N Janicky | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Courtney R Ferreira | Registered Dietitian Or Nutrition Professional | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Michael Foley | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Jordan C Altekruse | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Ian Lawrence Sikora | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Michael D Wah | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Ellen M Hangen | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Michael T Smith | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Alexandra A Zeno | Physical Therapy | Active Life and Sports Therapy LLC | 4337 Ebenezer Rd, Nottingham, MD 21236-2143 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Camille B Madison | Emergency Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Erin E Derenick | Physical Therapy | Gold Medal Physical Therapy LLC | 9634 Bel Air Rd, Perry Hall, MD 21236 |
| Andrew Davis | Psychiatry | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Alyssa M Mathew | Internal Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Kiersten E Kilczewski | Physical Therapy | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Tamischer B Nettles | Family Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Meeta Gulati | Internal Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Jenaro John Hernandez | Internal Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Julian Barkan | Emergency Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Jamille Patrice Taylor | Emergency Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Find all physicians in zip 21236 | |||
| City | NOTTINGHAM |
| Zip Code | 21236 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | NOTTINGHAM + PHYSICAL THERAPY |
Please comment or provide details below to improve the information on Glascow P Tennille Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.