Organization
IMPACT SPORTS & SPINE LLC
Active
Organization
IMPACT SPORTS & SPINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ITSKEVICH DO (CO-FOUNDER/PHYSICIAN)
(301) 363-9693
Entity
Organization
Contact information
Practice address
9420 KEY WEST AVE STE 325, ROCKVILLE, MD 20850-6529
(703) 789-3216
Mailing address
9420 KEY WEST AVE STE 325, ROCKVILLE, MD 20850-6529
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Enumeration date
06/04/2024
Last updated
08/02/2024
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