# MARYLAND SPORTSCARE & REHAB, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PIVOT PHYSICAL THERAPY OF MARYLAND
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255799870
- **Authorized official:** TASHEDA BROUGHTON PESC (MANAGER, CREDENTIALING)
- **Authorized official phone:** (252) 248-3313

## Contact information

- **Practice address:** 844 WASHINGTON RD, STE 102, WESTMINSTER, MD 21157-6664
- **Practice address phone:** (410) 876-5600
- **Practice address fax:** (410) 876-3818
- **Mailing address:** 2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
- **Mailing address phone:** (252) 248-3313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 02/10/2016
- **Last updated:** 10/16/2024