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Organization
SPINE & SPORTS PHYSICAL THERAPY & DIAGNOSTICS, LLC
Active
Organization
SPINE & SPORTS PHYSICAL THERAPY & DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES DAVIS II M.D. (SOLE MEMBER)
(410) 625-5050
Entity
Organization
Contact information
Practice address
1406B CRAIN HWY S, SUITE 107, GLEN BURNIE, MD 21061-4099
(410) 625-5050
(410) 766-1404
Mailing address
1406B CRAIN HWY S, SUITE 107, GLEN BURNIE, MD 21061-4099
(410) 625-5050
(410) 766-1404
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/02/2016
Last updated
04/04/2016
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