MEDICARE: TRUE SPORTS PHYSICAL THERAPY, LLC

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1922688670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUE SPORTS PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	2240 GREENSPRING DR
Second Line	:
City	:	TIMONIUM
State	:	MD
Zip	:	21093-3114
Country	:	US
Telephone Number	:	410-989-3833
Fax Number	:

Provider Business Practice Location Address
First Line	:	7450 NEW TECHNOLOGY WAY STE C
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21703-8446
Country	:	US
Telephone Number	:	410-989-3833
Fax Number	:	410-946-1920

Authorized Official
Title or Position	:	OWNER
Name	:	JONATHAN A ROSENBLATT
Credential	:	DPT
Telephone Number	:	410-989-3833

Provider Enumeration Date	:	04/08/2021
Last Update Date	:	04/08/2021

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