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General NPI Number Information
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NPI Number | 1972795169
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE SPINE & SPORTS CENTER, PC
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 08/13/2007
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Provider Practice Location Address
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Address Line | 1308 EASTERN BLVD
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City | BALTIMORE
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State | MD
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Zip | 21221-3423
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Country | US
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Telephone | 410-686-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 1308 EASTERN BLVD
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City | BALTIMORE
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State | MD
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Zip | 21221-3423
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Country | US
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Telephone | 410-686-8400
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Fax |
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Authorized Official
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Title or Position | PRES.
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Name | DR. NEIL COHEN
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Credential |
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Telephone | 410-686-8400
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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 | S01560PT
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License Number State | MD
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