# GLEN BURNIE PHYSICAL THERAPY & SPORTSCARE, LLC

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

## Provider details

- **NPI number:** 1396107199
- **Authorized official:** JUANA GRANADOS (CREDENTIALING DIRECTOR)
- **Authorized official phone:** (630) 575-1980

## Contact information

- **Practice address:** 1460 RITCHIE HWY, STE 113, 114, ARNOLD, MD 21012-2730
- **Practice address phone:** (410) 626-8350
- **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 |

## Other

- **Enumeration date:** 03/22/2016
- **Last updated:** 09/15/2025