Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Spine & Sports Physical Therapy & Diagnostics, LLC

Organization Neurology Physician · NPI 1083077499

Spine & Sports Physical Therapy & Diagnostics, LLC is a Neurology Physician in Glen Burnie, Maryland. Registered with an NPI since 2016.

In the registry since
2016
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1406B Crain Hwy S Ste 107
Glen Burnie, MD 21061-4099
Phone: (410) 625-5050
Fax: (410) 766-1404
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X
Neurology Physician Taxonomy 2084N0400X

Record details

NPI number1083077499
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Davis — Sole Member · (410) 625-5050
NPI enumeratedApril 2, 2016
Last updated in NPPESApril 4, 2016
Mailing address1406b Crain Hwy S, Suite 107, Glen Burnie, MD 21061-4099

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