Healthcare Provider Details

I. General information

NPI: 1770361172
Provider Name (Legal Business Name): DICKSON PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 TILGHMAN RD STE 200
SALISBURY MD
21804-2078
US

IV. Provider business mailing address

329 TILGHMAN RD STE 200
SALISBURY MD
21804-2078
US

V. Phone/Fax

Practice location:
  • Phone: 443-203-8522
  • Fax: 443-736-3000
Mailing address:
  • Phone: 443-203-8522
  • Fax: 443-736-3000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TANYA DICKSON
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: DPT
Phone: 443-614-4772