# EVOLUTION SPORTS PHYSIOTHERAPY - WHITE MARSH, LLC

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

## Provider details

- **NPI number:** 1134519838
- **Authorized official:** DR. MORGAN SANDFORD JOHNSON JR. PT, DPT (OWNER / PARTNET)
- **Authorized official phone:** (443) 955-3515

## Contact information

- **Practice address:** 10540 YORK RD, SUITE F, COCKEYSVILLE, MD 21030-2300
- **Practice address phone:** (443) 955-3515
- **Practice address fax:** (410) 628-0542
- **Mailing address:** 11605 CROSSROADS CIR, D-E, MIDDLE RIVER, MD 21220-2865
- **Mailing address phone:** (443) 955-3515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 20554 | MD | Yes |

## Other

- **Enumeration date:** 02/02/2015
- **Last updated:** 02/02/2015