Healthcare Provider Details

I. General information

NPI: 1356884449
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: 11/22/2016
Last Update Date: 11/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 S SALISBURY BLVD STE B
SALISBURY MD
21801-7162
US

IV. Provider business mailing address

11070 CATHELL RD STE 4
BERLIN MD
21811-9344
US

V. Phone/Fax

Practice location:
  • Phone: 443-736-4091
  • Fax: 443-736-4358
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