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General NPI Number Information
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NPI Number | 1225650633
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Entity Type | Organization
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Legal Business Name | BIRCH TREE PHYSICAL THERAPY AND WELLNESS, LLC
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 2000 GIRARD AVE
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City | BALTIMORE
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State | MD
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Zip | 21211-1595
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Country | US
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Telephone | 443-977-4470
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Fax |
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Provider Business Mailing Address
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Address Line | 611 S PACA ST
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City | BALTIMORE
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State | MD
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Zip | 21230-2411
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Country | US
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Telephone | 443-801-1472
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | DR. SEAN VINCENT MCCOMISKEY
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Credential | PT, DPT
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Telephone | 443-977-4470
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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 |
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License Number State |
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