Provider Demographics
NPI:1023539178
Name:TRUE SPORTS PHYSICAL THERAPY 2, LLC
Entity Type:Organization
Organization Name:TRUE SPORTS PHYSICAL THERAPY 2, LLC
Other - Org Name:TRUE SPORTS PHYSICAL THERAPY 2, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:ARON
Authorized Official - Last Name:ROSENBLATT
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CSCS, OCS,
Authorized Official - Phone:410-215-6621
Mailing Address - Street 1:3307 TIMBERFIELD LN
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4425
Mailing Address - Country:US
Mailing Address - Phone:410-215-6621
Mailing Address - Fax:
Practice Address - Street 1:15870 FREDERICK RD
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:MD
Practice Address - Zip Code:21797-8528
Practice Address - Country:US
Practice Address - Phone:410-215-6621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1622261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy