# 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:** 1609232016
- **Authorized official:** TASHEDA BROUGHTON PESC (MANAGER, CREDENTIALING)
- **Authorized official phone:** (252) 248-3313

## Contact information

- **Practice address:** 25 MAIN ST STE A, REISTERSTOWN, MD 21136-1248
- **Practice address phone:** (410) 833-8300
- **Practice address fax:** (410) 833-8308
- **Mailing address:** 2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
- **Mailing address phone:** (252) 248-3313
- **Mailing address fax:** (410) 648-4878

## Taxonomy

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

## Other

- **Enumeration date:** 01/14/2016
- **Last updated:** 11/01/2024