# BAYSIDE PHYSICAL THERAPY AND SPORTS REHABILITATION, INC.

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

## Provider details

- **NPI number:** 1417009408
- **Authorized official:** NANCY FORD (BUSINESS MANAGER)
- **Authorized official phone:** (410) 956-4308

## Contact information

- **Practice address:** 8601 VETERANS HWY, SUITE 212, MILLERSVILLE, MD 21108-1547
- **Practice address phone:** (410) 987-2162
- **Mailing address:** 3179 BRAVERTON ST, SUITE 201, EDGEWATER, MD 21037-2665
- **Mailing address phone:** (410) 956-4308

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 01/18/2007
- **Last updated:** 08/22/2020