Organization
CROFTON PHYSICAL THERAPY & SPORTS REHAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN DENISE FRYE (PRESIDENT)
(410) 721-9000
Entity
Organization
Contact information
Practice address
2200 DEFENSE HWY, 200, CROFTON, MD 21114-2926
(410) 721-9000
(410) 721-8185
Mailing address
2200 DEFENSE HWY, 200, CROFTON, MD 21114-2926
(410) 721-9000
(410) 721-8185
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2598572
AETNA HMO GROUP NUMBER
MD
01
—
5001459
AETNA PPO GROUP NUMBER
MD
01
—
KY69CR
CAREFIRST BC/BS GROUP NUM
MD
01
—
R926
CAREFIRST BC/BS HMO/FEP
MD
Enumeration date
01/06/2006
Last updated
08/22/2020
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