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Organization
SOVEREIGNTY HEALTH SERVICES LLC
Active
Organization
SOVEREIGNTY HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEHINDE TIJANI (OTR/L)
(410) 940-1983
Entity
Organization
Contact information
Practice address
5310 OLD COURT RD, RANDALLSTOWN, MD 21133-5243
(410) 940-1983
Mailing address
152 SPECTATOR LN, OWINGS MILLS, MD 21117-4444
(410) 940-1983
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/05/2020
Last updated
05/29/2024
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