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Organization
EXECUTIVE REHABILITATION & SPORTS THERAPY, INC.
Active
Organization
EXECUTIVE REHABILITATION & SPORTS THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN B SARGEANT (OWNER)
(301) 816-0020
Entity
Organization
Contact information
Practice address
6000 EXECUTIVE BLVD, SUITE #201, ROCKVILLE, MD 20852-3803
(301) 816-0020
(301) 816-0334
Mailing address
6000 EXECUTIVE BLVD, SUITE #201, ROCKVILLE, MD 20852-3803
(301) 816-0020
(301) 816-0334
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14262
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K366
BCBS/ NON PAR
MD
Enumeration date
03/22/2006
Last updated
08/22/2020
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