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
305 10TH ST STE 102, POCOMOKE CITY, MD 21851-1607
(410) 957-4396
(410) 957-4398
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(252) 248-3313
(410) 648-4878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
12/17/2021
Last updated
11/01/2024
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