Healthcare Provider Details

I. General information

NPI: 1427055912
Provider Name (Legal Business Name): TRC MID ATLANTIC,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 12/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2760 PINE GROVE RD
YORK PA
17403-5170
US

IV. Provider business mailing address

7401 OSLER DR SUITE 110
TOWSON MD
21204-7673
US

V. Phone/Fax

Practice location:
  • Phone: 717-741-5118
  • Fax:
Mailing address:
  • Phone: 410-296-8888
  • Fax: 410-296-6745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MARK FIORINO
Title or Position: PRESIDENT
Credential: P.T.
Phone: 410-296-8888