Healthcare Provider Details

I. General information

NPI: 1225248891
Provider Name (Legal Business Name): MARK NELSON REKOS PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 EAST MAIN STREET SUITE A
SALISBURY MD
21804
US

IV. Provider business mailing address

218 LONG AVENUE
SALISBURY MD
21804
US

V. Phone/Fax

Practice location:
  • Phone: 443-260-3050
  • Fax:
Mailing address:
  • Phone: 443-260-2341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberA2614
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA2614
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: