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General NPI Number Information
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NPI Number | 1982384665
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Entity Type | Organization
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Legal Business Name | SAGE PHYSICAL THERAPY & WELLNESS, LLC
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Dates
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Enumeration Date | 07/19/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 1324 BELMONT AVE STE 101
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City | SALISBURY
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State | MD
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Zip | 21804-4543
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Country | US
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Telephone | 410-656-9953
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Fax |
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Provider Business Mailing Address
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Address Line | 802 CROMWELL PARK DR STE T
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City | GLEN BURNIE
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State | MD
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Zip | 21061-2563
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Country | US
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Telephone | 703-239-2300
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | CHARLES SHOENFELT
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Credential |
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Telephone | 410-553-9686
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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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