Healthcare Provider Details
I. General information
NPI: 1114883998
Provider Name (Legal Business Name): BALTIMORE INJURY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/24/2025
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
756 WASHINGTON BLVD
BALTIMORE MD
21230-2332
US
IV. Provider business mailing address
409 WASHINGTON AVE STE 900
TOWSON MD
21204-4905
US
V. Phone/Fax
- Phone: 410-444-1400
- Fax:
- Phone: 410-494-0100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FREDDIE
J.
TRAUB
Title or Position: ATTORNEY
Credential: J.D.
Phone: 410-494-0100