Healthcare Provider Details

I. General information

NPI: 1720936875
Provider Name (Legal Business Name): C&M PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6041 OTTERBEIN LN APT 406
ELLICOTT CITY MD
21043-7599
US

IV. Provider business mailing address

6041 OTTERBEIN LN APT 406
ELLICOTT CITY MD
21043-7599
US

V. Phone/Fax

Practice location:
  • Phone: 631-377-2719
  • Fax:
Mailing address:
  • Phone: 631-377-2719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SHANICE CARRINGTON
Title or Position: PHYSICAL THERAPIST/OWNER
Credential: PT, DPT
Phone: 631-377-2719