MEDICARE: EMBARK PHYSIO AND PERFORMANCE

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1386416881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBARK PHYSIO AND PERFORMANCE

Provider Business Mailing Address
First Line	:	7705 LEXINGTON CT
Second Line	:
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-7505
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 PENROD CT
Second Line	:
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-2837
Country	:	US
Telephone Number	:	443-256-6748
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	ZACHARY HUNTER WOOLEVER
Credential	:	PT, DPT
Telephone Number	:	603-562-8175

Provider Enumeration Date	:	10/27/2023
Last Update Date	:	06/09/2025

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Directions to “EMBARK PHYSIO AND PERFORMANCE ” Practice Location

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