Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 18872 | MD |
NPI | 1083026769 |
---|---|
Provider Name | Anneliese H Massey |
First Address | Baltimore, MD 21239-2945 |
Second Address | Baltimore, MD 21239-2945 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2014 |
Last Update Date | 29/05/2014 |