MEDICARE: SALISBURY PHYSICAL THERAPY & SPORTSMEDICINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	15888	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	328A	OTHER	MD	CAREFIRST
3	S402	OTHER	MD	FEDERAL BCBS

General Provider Information

NPI Number	:	1164641437
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALISBURY PHYSICAL THERAPY & SPORTSMEDICINE

Provider Business Mailing Address
First Line	:	949 MOUNT HERMON RD
Second Line	:
City	:	SALISBURY
State	:	MD
Zip	:	21804-5105
Country	:	US
Telephone Number	:	410-543-9000
Fax Number	:	410-543-9033

Provider Business Practice Location Address
First Line	:	305 10TH ST
Second Line	:	SUITE 102
City	:	POCOMOKE CITY
State	:	MD
Zip	:	21851-1607
Country	:	US
Telephone Number	:	410-543-9000
Fax Number	:	410-543-9033

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	MARY ANN MASSEY
Credential	:
Telephone Number	:	410-543-9000

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	07/12/2010

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Directions to “SALISBURY PHYSICAL THERAPY & SPORTSMEDICINE ” Practice Location

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