Breakaway Physical Therapy, LLC
Physical Therapist in Crofton, MD. Organization (NPI-2).
NPI number1780077784
StatusActive
Last updated in NPPESOct 26, 2020
Details
- NPI
- 1780077784
- Entity type
- Organization (NPI-2)
- Legal business name
- Breakaway Physical Therapy, LLC
- Organization subpart
- No
- Enumeration date
- Mar 15, 2015
- Certification date
- Oct 26, 2020
- Last updated
- Oct 26, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
Practice location
2138 Priest Bridge Ct Ste 7Crofton, MD 21114-2463
Phone 410-721-6333 · Fax 410-721-7651
Mailing address
Po Box 4704Crofton, MD 21114-4704
Phone 410-721-6333 · Fax 410-721-7651
Authorized official
Shaina Clemons
Owner
4107216333
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All 22 Physical Therapist providers in Crofton · All 685 providers in Crofton
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