Organization
PERFORMANCE PHYSICAL THERAPY AND SPORTS REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY HICKERSON HITE DPT (OWNER/PHYSICAL THERAPIST)
(410) 997-2585
Entity
Organization
Contact information
Practice address
9194 RED BRANCH RD STE J, COLUMBIA, MD 21045-2005
(410) 997-2585
(410) 997-2586
Mailing address
9194 RED BRANCH RD STE J, COLUMBIA, MD 21045-2005
(410) 997-2585
(410) 997-2586
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
04/09/2018
Last updated
03/18/2025
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