Healthcare Provider Details

I. General information

NPI: 1851990360
Provider Name (Legal Business Name): BREATHE FREE PHYSICAL THERAPY & YOGA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2020
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 REISTERSTOWN RD STE 109
PIKESVILLE MD
21208-2978
US

IV. Provider business mailing address

711 OLD CROSSING DRIVE
BALTIMORE MD
21208
US

V. Phone/Fax

Practice location:
  • Phone: 410-908-5595
  • Fax:
Mailing address:
  • Phone: 410-908-5595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251H1300X
TaxonomyHuman Factors Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELISSA WOHLBERG
Title or Position: FOUNDER
Credential: PT, DPT, RY200
Phone: 410-908-5595