Organization
PROFORMANCE SPORTS REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDEN JACK COHEN DPT (OWNER/PHYSICAL THERAPIST)
(860) 917-7610
Entity
Organization
Contact information
Practice address
116 BERRYWOOD DR, SEVERNA PARK, MD 21146-2004
(443) 203-9388
(443) 775-3607
Mailing address
2637 STREAMVIEW DR, ODENTON, MD 21113-1579
(860) 917-7610
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
09/22/2018
Last updated
10/28/2024
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