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Organization
REVOLUTION REHABILITATION AND SPORTS PERFORAMANCE LLC
Active
Organization
REVOLUTION REHABILITATION AND SPORTS PERFORAMANCE LLC
Active
Other names
Revolution Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW SEAN BOURDEAU DPT (PHYSICAL THERAPIST)
(301) 848-2284
Entity
Organization
Contact information
Practice address
1100 RUSSELL ST, BALTIMORE, MD 21230-2622
(301) 848-2284
Mailing address
2653 CEDAR ELM DR, ODENTON, MD 21113-2905
(301) 848-2284
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
23944
MD
261QP2000X
Physical Therapy Clinic/Center
Primary
24069
MD
Other
Enumeration date
03/05/2015
Last updated
04/02/2015
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