Organization
IMPACT SPORTS PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT ESBRANDT PT,DPT, PES (OWNER, PHYSICAL THERAPIST)
(410) 322-9777
Entity
Organization
Contact information
Practice address
7468 CANDLEWOOD RD, HANOVER, MD 21076-3211
(410) 684-5642
Mailing address
8816 DOVE DR, PERRY HALL, MD 21128-9000
(410) 322-9777
(443) 632-0521
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
25008
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013316884
INDIVIDUAL NPI ROBERT ESBRANDT
—
01
—
1780097113
INDIVIDUAL NPI
—
01
—
25008
MARYLAND PT LICENSE
—
01
—
W18167155
LLC ID #
—
Enumeration date
08/02/2017
Last updated
08/10/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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