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General NPI Number Information
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NPI Number | 1053477935
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Entity Type | Organization
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Legal Business Name | CAMBRIDGE PHYSICAL THERAPY AND SPORTS CARE, LLC
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 10/15/2019
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Provider Practice Location Address
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Address Line | 321 DORCHESTER AVE SUITE B
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City | CAMBRIDGE
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State | MD
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Zip | 21613-2425
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Country | US
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Telephone | 410-228-5100
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Fax | 410-228-7479
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Provider Business Mailing Address
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Address Line | 350 NEW FIDELITY CT
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City | GARNER
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State | NC
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Zip | 27529-2665
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Country | US
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Telephone | 919-258-2714
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Fax | 410-820-4330
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Authorized Official
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Title or Position | CEO
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Name | CHRISTOPHER THROCKMORTON
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Credential |
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Telephone | 919-258-2714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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