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General NPI Number Information
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NPI Number | 1003855461
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Entity Type | Organization
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Legal Business Name | ATLANTIC REHAB, INC
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 5 CRAIN HWY N SUITE 103
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City | GLEN BURNIE
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State | MD
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Zip | 21061-2803
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Country | US
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Telephone | 410-768-9500
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Fax | 410-768-5200
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Provider Business Mailing Address
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Address Line | 5 CRAIN HWY N SUITE 103
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City | GLEN BURNIE
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State | MD
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Zip | 21061-2803
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Country | US
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Telephone | 410-768-9500
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Fax | 410-768-5200
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Authorized Official
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Title or Position | DIRECTOR
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Name | RONALD M. KELCH
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Credential | PTA, MS, JSCC
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Telephone | 410-768-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | A1924
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License Number State | MD
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