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
401 MARVEL CT STE A, EASTON, MD 21601-4048
(410) 820-4449
(410) 820-4330
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(252) 248-3313
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/10/2020
Last updated
10/23/2024
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