# 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:** 1801411467
- **Authorized official:** TASHEDA BROUGHTON PESC (MANAGER, CREDENTIALING)
- **Authorized official phone:** (252) 248-3313

## Contact information

- **Practice address:** 314 FRANKLIN AVE STE 501, BERLIN, MD 21811-1264
- **Practice address phone:** (410) 641-0999
- **Mailing address:** 2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
- **Mailing address phone:** (252) 248-3313
- **Mailing address fax:** (410) 678-4878

## Taxonomy

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

## Other

- **Enumeration date:** 06/10/2020
- **Last updated:** 11/01/2024