OrganizationActive
Breakaway Physical Therapy, LLC
NPI 1780077784 · Physical Therapist · Crofton, MD
Provider details
- NPI number
- 1780077784
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Authorized official
- Shaina Clemons, Owner
Practice location
2138 Priest Bridge Ct Ste 7
Crofton, MD 21114-2463
Phone: (410) 721-6333
Fax: (410) 721-7651
Mailing address
Po Box 4704
Crofton, MD 21114-4704
Registry dates
- Enumerated
- 2015-03-15
- Last updated
- 2020-10-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.