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Organization
PENINSULA REHAB & SPORTS MEDICINE, INC.
Active
Organization
PENINSULA REHAB & SPORTS MEDICINE, INC.
Active
Parent organization
PENINSULA REHAB & SPORTS MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENINSULA REHAB & SPORTS MEDICINE
Authorized official
MR. RONALD MARC WIST P.T. (OWNER/PRESIDENT)
(410) 213-7878
Entity
Organization
Contact information
Practice address
12913 COASTAL HWY, OCEAN CITY, MD 21842-4718
(410) 213-7878
(410) 213-7879
Mailing address
12417 OCEAN GTWY, #9, OCEAN CITY, MD 21842-9521
(410) 213-7878
(410) 213-7879
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23989297
MD
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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