Professional Sportscare & Rehab, LLC

NPI #1629523733 in Herndon, Virginia

Provider Information

NPI Number: 1629523733
Entity Type: Organization
Organization Name: Professional Sportscare & Rehab, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Aug 18, 2016
Last Updated: Dec 6, 2024

Practice Location

Address: 13043 WORLDGATE DR
City: Herndon
State: Virginia
ZIP Code: 20170-4374
Phone: (703) 870-2450

Authorized Official

Name: TASHEDA BROUGHTON, PESC
Title: MANAGER, CREDENTIALING
Phone: (252) 248-3313

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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