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General NPI Number Information
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NPI Number | 1093011017
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Entity Type | Organization
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Legal Business Name | SPORTS HYPERBARICS, LLC
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Dates
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Enumeration Date | 02/09/2011
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 8227 CLOVERLEAF DR SUITE 303
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City | MILLERSVILLE
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State | MD
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Zip | 21108-1565
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Country | US
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Telephone | 410-729-4268
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Fax | 443-458-0121
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Provider Business Mailing Address
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Address Line | 8227 CLOVERLEAF DR SUITE 303
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City | MILLERSVILLE
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State | MD
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Zip | 21108-1565
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Country | US
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Telephone | 410-729-4268
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Fax | 443-458-0121
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Authorized Official
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Title or Position | PRESIDENT
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Name | JASON M SHAPIRO
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Credential |
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Telephone | 410-729-4268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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