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Organization
BAYSIDE PHYSICAL THERPAY AND SPORTS REHABILITATION, INC
Active
Organization
BAYSIDE PHYSICAL THERPAY AND SPORTS REHABILITATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN C. WRENN D.P.T. (VICE PRESIDENT)
(410) 956-4308
Entity
Organization
Contact information
Practice address
3179 BRAVERTON ST, SUITE 201, EDGEWATER, MD 21037-2665
(410) 956-4308
Mailing address
3179 BRAVERTON ST, SUITE 201, EDGEWATER, MD 21037-2665
(410) 956-4308
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
NULL
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
11/07/2006
Last updated
09/11/2025
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