# SUNDANCE REHABILITATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104160662
- **Authorized official:** MISS SUSAN P JORDAN PTA (PHYSICAL THERAPIST ASSISTANT)
- **Authorized official phone:** (410) 479-2130

## Contact information

- **Practice address:** 520 KERR AVE, DENTON, MD 21629-1343
- **Practice address phone:** (410) 479-2130
- **Practice address fax:** (410) 479-3057
- **Mailing address:** 200 NORTHPOINTE CIR STE 302, SEVEN FIELDS, PA 16046-7861
- **Mailing address phone:** (800) 815-8577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 273Y00000X | Rehabilitation Hospital Unit | A3417 | MD | Yes |

## Other

- **Enumeration date:** 11/21/2012
- **Last updated:** 11/21/2012