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Organization
SPORT & SPINE REHAB OF FORT WASHINGTON, LLC
Active
Organization
SPORT & SPINE REHAB OF FORT WASHINGTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY S GREENSTEIN DC (CEO)
(240) 766-0300
Entity
Organization
Contact information
Practice address
11418 LIVINGSTON RD, FT WASHINGTON, MD 20744-5145
(240) 766-0300
(240) 766-0304
Mailing address
11418 LIVINGSTON RD, FT WASHINGTON, MD 20744-5145
(240) 766-0300
(240) 766-0304
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1049260
ASHN CIGNA HMO
—
01
—
31816933
AETNA HMO
—
01
—
467B
BCBS OF MD
—
01
—
6115086
OPTIMUM CHOICE
—
01
—
671810
CIGNA PPO
—
01
—
7253478
AETNA PPO
—
01
—
ALLIANCE
6115086
—
01
—
DEPT OF LABOR
611056000
—
01
—
K219
BCBS OF NCA
—
01
—
MAMSI
6115086
—
01
—
MDIPA
6115086
—
Enumeration date
05/02/2007
Last updated
03/26/2024
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