# INJURY TREATMENT CENTER OF MARYLAND,LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992824486
- **Authorized official:** EVAN J WAGENHEIM (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (410) 922-2300

## Contact information

- **Practice address:** 8660 LIBERTY RD, RANDALLSTOWN, MD 21133-4707
- **Practice address phone:** (410) 922-2300
- **Mailing address:** 8660 LIBERTY RD, RANDALLSTOWN, MD 21133-4707
- **Mailing address phone:** (410) 922-2300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | MD | Yes |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 03/28/2007
- **Last updated:** 09/11/2025