Organization
GLEN BURNIE PHYSICAL THERAPY & SPORTSCARE, LLC
Active
Other names
PIVOT PHYSICAL THERAPY OF GREATER BALTIMORE
Organization subpart
No
Provider details
NPI number
Authorized official
TASHEDA BROUGHTON PESC (MANAGER, CREDENTIALING)
(252) 248-3313
Entity
Organization
Contact information
Practice address
8890 CENTRE PARK DR, SUITE 400, COLUMBIA, MD 21045-2188
(410) 884-6000
Mailing address
2122 YORK RD STE 500, OAK BROOK, IL 60523-1930
(252) 248-3313
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
03/22/2016
Last updated
11/01/2024
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