Organization
DYNAMIC THERAPY SERVICES LLC
Active
Other names
Dynamic Physical Therapy, Pivot Therapy of Mid Atlantic, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TASHEDA BROUGHTON PESC (MANAGER, CREDENTIALING)
(252) 248-3313
Entity
Organization
Contact information
Practice address
550 STANTON CHRISTIANA RD STE 203, NEWARK, DE 19713-2125
(302) 691-5603
(302) 691-5623
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(252) 248-3313
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
08/25/2017
Last updated
12/09/2024
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