Organization
MARYLAND SPORTSCARE & REHAB LLC
Active
Other names
Professional Sports Care Rehab of West Virginia, LLC, Pivot Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TASHEDA BROUGHTON PESC (MANAGER, CREDENTIALING)
(252) 248-3313
Entity
Organization
Contact information
Practice address
10220 RIVER RD STE 2, POTOMAC, MD 20854-4907
(301) 897-3890
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(522) 348-3313
(410) 648-4878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/21/2017
Last updated
09/24/2024
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