Healthcare Provider Details

I. General information

NPI: 1013493303
Provider Name (Legal Business Name): ATLANTIC PHYSICAL THERAPY REHABILITATION AND SPORTS MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10231 OLD OCEAN CITY BLVD STE 1
BERLIN MD
21811-3566
US

IV. Provider business mailing address

11070 CATHELL RD STE 4
BERLIN MD
21811-9344
US

V. Phone/Fax

Practice location:
  • Phone: 888-208-3828
  • Fax:
Mailing address:
  • Phone: 410-208-3630
  • Fax: 410-208-3633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: ROBIN CUMMINGS
Title or Position: CORPORATE MANAGER
Credential:
Phone: 410-208-3630