Organization
MARYLAND SPORTSCARE & REHAB LLC
Active
Other names
Pivot Physical Therapy of Maryland
Organization subpart
No
Provider details
NPI number
Authorized official
TASHEDA BROUGHTON PESC (MANAGER, CREDENTIALING)
(252) 248-3313
Entity
Organization
Contact information
Practice address
2540 PULASKI HWY STE B, NORTH EAST, MD 21901-2610
(410) 339-1960
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(252) 248-3133
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
02/04/2019
Last updated
11/01/2024
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