Healthcare Provider Details

I. General information

NPI: 1386615219
Provider Name (Legal Business Name): SALISBURY PHYSICAL THERAPY & SPORTSMEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 11/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

949 MOUNT HERMON RD
SALISBURY MD
21804-5105
US

IV. Provider business mailing address

949 MOUNT HERMON RD
SALISBURY MD
21804-5105
US

V. Phone/Fax

Practice location:
  • Phone: 410-543-9000
  • Fax: 410-543-9033
Mailing address:
  • Phone: 410-543-9000
  • Fax: 410-543-9033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number15888
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number15888
License Number StateMD

VIII. Authorized Official

Name: MR. ROBERT STEPHEN BARTOSHESKY
Title or Position: OWNER
Credential: P.T.
Phone: 410-543-9000