Organization
GLEN BURNIE PHYSICAL THERAPY & SPORTSCARE, LLC
Active
Other names
Pasadena Glen Burnie PT Offices, Pivot Physical Therapy of Greater Baltimore
Organization subpart
No
Provider details
NPI number
Authorized official
TASHEDA BROUGHTON (CREDENTIALING MANAGER)
(252) 248-3313
Entity
Organization
Contact information
Practice address
5500 KNOLL NORTH DR STE 150, COLUMBIA, MD 21045-2476
(443) 542-0062
(443) 542-0250
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
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
01/03/2007
Last updated
11/01/2024
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