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Organization
PERFORMANCE PHYSICAL THERAPY AND SPORTS REHABILITATION LLC
Active
Organization
PERFORMANCE PHYSICAL THERAPY AND SPORTS REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY HICKERSON HITE DPT (OWNER/PHYSICAL THERAPIST)
(410) 997-2585
Entity
Organization
Contact information
Practice address
9194 RED BRANCH RD STE J, COLUMBIA, MD 21045-2005
(410) 997-2585
(410) 997-2586
Mailing address
9194 RED BRANCH RD STE J, COLUMBIA, MD 21045-2005
(410) 997-2585
(410) 997-2586
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
04/09/2018
Last updated
03/18/2025
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