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General NPI Number Information
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NPI Number | 1396540399
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Entity Type | Organization
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Legal Business Name | SHORE ELITE PHYSICAL THERAPY
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 112 LOG CANOE CIR
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City | STEVENSVILLE
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State | MD
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Zip | 21666-2128
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Country | US
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Telephone | 410-443-7372
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Fax |
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Provider Business Mailing Address
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Address Line | 57 LONG CREEK DR
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City | STEVENSVILLE
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State | MD
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Zip | 21666-2959
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY / OWNER
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Name | ASHLEY GOOD
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Credential |
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Telephone | 443-569-9267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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