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Organization
INJURY TREATMENT CENTER OF MARYLAND,LLC
Active
Organization
INJURY TREATMENT CENTER OF MARYLAND,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN J WAGENHEIM (PRACTICE ADMINISTRATOR)
(410) 922-2300
Entity
Organization
Contact information
Practice address
8660 LIBERTY RD, RANDALLSTOWN, MD 21133-4707
(410) 922-2300
Mailing address
8660 LIBERTY RD, RANDALLSTOWN, MD 21133-4707
(410) 922-2300
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
MD
225100000X
Physical Therapist
—
—
Other
Enumeration date
03/28/2007
Last updated
09/11/2025
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