Healthcare Provider Details

I. General information

NPI: 1306605209
Provider Name (Legal Business Name): SYNERGY IN MOTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2024
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8651 FORT SMALLWOOD RD STE 1
PASADENA MD
21122-2445
US

IV. Provider business mailing address

545 BALTIMORE ANNAPOLIS BLVD
SEVERNA PARK MD
21146-3809
US

V. Phone/Fax

Practice location:
  • Phone: 410-315-9080
  • Fax:
Mailing address:
  • Phone:
  • 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: ROMMER DIZON
Title or Position: OWNER
Credential:
Phone: 410-315-9080