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General NPI Number Information
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NPI Number | 1386318707
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Entity Type | Organization
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Legal Business Name | INNOVATIVE PHYSICAL THERAPY AND FITNESS CENTERS LLC
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Dates
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Enumeration Date | 08/09/2021
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 136 S PHILADELPHIA BLVD STE C
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City | ABERDEEN
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State | MD
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Zip | 21001-3203
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Country | US
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Telephone | 443-512-8337
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Fax |
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Provider Business Mailing Address
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Address Line | 9526 PHILADELPHIA RD
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City | ROSEDALE
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State | MD
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Zip | 21237-4106
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Country | US
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Telephone | 443-512-8337
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Fax | 443-327-5282
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Authorized Official
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Title or Position | OWNER
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Name | BRYAN MORROW
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Credential | MSPT
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Telephone | 443-512-8337
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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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