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, CREDENTIALING)
(252) 248-3313
Entity
Organization
Contact information
Practice address
3100 BOSTON STREET, BALTIMORE, MD 21298-0001
(919) 258-2714
Mailing address
350 NEW FIDELITY CT, GARNER, NC 27529-2665
(919) 258-2714
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
06/21/2019
Last updated
11/01/2024
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