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General NPI Number Information
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NPI Number | 1164622643
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Entity Type | Organization
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Legal Business Name | SALISBURY MUSCULOSKELETAL CLINIC
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 10/04/2007
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Provider Practice Location Address
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Address Line | 32071 BEAVER RUN DR STE B
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City | SALISBURY
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State | MD
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Zip | 21804-1773
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Country | US
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Telephone | 410-341-6520
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Fax | 410-341-6526
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Provider Business Mailing Address
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Address Line | 32071 BEAVER RUN DR STE B P.O. BOX 1859
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City | SALISBURY
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State | MD
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Zip | 21804-1773
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Country | US
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Telephone | 410-341-6520
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Fax | 410-341-6526
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Authorized Official
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Title or Position | PARTNER
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Name | DR. PETER SEBASTIAN
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Credential | D.O.
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Telephone | 410-341-6520
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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 | Q00754
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License Number State | MD
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