# STRIATIONS FITNESS SPORTS MEDICINE AND OCCUPATIONAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1376853838
- **Authorized official:** MR. RANDALL SHAWN WATKINS SR. OTR/L, ATC, NSCA-CPT (PRESIDENT/OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (443) 850-1447

## Contact information

- **Practice address:** 29 GREENMEADOW DR, TIMONIUM, MD 21093-3256
- **Practice address phone:** (410) 823-0870
- **Mailing address:** 7923 SAINT MONICA DR, DUNDALK, MD 21222-3536
- **Mailing address phone:** (443) 850-1447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225XP0019X | Physical Rehabilitation Occupational Therapist | 06421 | MD | Yes |

## Other

- **Enumeration date:** 10/18/2010
- **Last updated:** 12/13/2010