Provider Demographics
NPI:1427594415
Name:CAMBRIDGE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:CAMBRIDGE PHYSICAL THERAPY, LLC
Other - Org Name:PIVOT PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:THROCKMORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-885-4932
Mailing Address - Street 1:501 FAIRMOUNT AVE
Mailing Address - Street 2:STE 302
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5457
Mailing Address - Country:US
Mailing Address - Phone:410-927-8768
Mailing Address - Fax:
Practice Address - Street 1:2618 N SALISBURY BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-2194
Practice Address - Country:US
Practice Address - Phone:410-324-7409
Practice Address - Fax:410-844-4588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-13
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty