Organization
REVOLUTION REHABILITATION AND SPORTS PERFORAMANCE LLC
Active
Other names
Revolution Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW SEAN BOURDEAU DPT (PHYSICAL THERAPIST)
(301) 848-2284
Entity
Organization
Contact information
Practice address
1100 RUSSELL ST, BALTIMORE, MD 21230-2622
(301) 848-2284
Mailing address
2653 CEDAR ELM DR, ODENTON, MD 21113-2905
(301) 848-2284
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
23944
MD
261QP2000X
Physical Therapy Clinic/Center
Primary
24069
MD
Other
Enumeration date
03/05/2015
Last updated
04/02/2015
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