Organization
MARYLAND SPORTSCARE & REHAB, LLC
Active
Other names
PIVOT PHYSICAL THERAPY OF MARYLAND
Organization subpart
No
Provider details
NPI number
Authorized official
TASHEDA BROUGHTON PESC (MANAGER, CREDENTIALLING)
(252) 248-3313
Entity
Organization
Contact information
Practice address
410 MEADOW CREEK DR, STE 106, WESTMINSTER, MD 21158-9426
(410) 861-5487
(443) 293-7924
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(522) 483-3132
(410) 648-4878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/14/2016
Last updated
10/16/2024
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