MEDICARE: LIBERTY MEDICAL &INJURY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251H1300X	Human Factors Physical Therapist

General Provider Information

NPI Number	:	1003031790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIBERTY MEDICAL &INJURY CENTER

Provider Business Mailing Address
First Line	:	7034 LIBERTY RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21207-5801
Country	:	US
Telephone Number	:	410-580-9191
Fax Number	:

Provider Business Practice Location Address
First Line	:	7034 LIBERTY RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21207-5801
Country	:	US
Telephone Number	:	410-580-9191
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MRS. ELINA MORIN
Credential	:
Telephone Number	:	410-580-9191

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	08/22/2020

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