Organization
MARYLAND SPORTSCARE & REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TASHEDA BROUGHTON PESC (CREDENTIALING MANAGER)
(252) 248-3313
Entity
Organization
Contact information
Practice address
75 THOMAS JOHNSON DR STE N, FREDERICK, MD 21702-4895
(301) 663-0009
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(252) 248-3313
(410) 678-4878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
11/16/2023
Last updated
11/01/2024
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