Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A3086 | MD |
NPI | 1013145689 |
---|---|
Provider Name | Bethany Rios |
First Address | Crofton, MD 21114-1864 |
Second Address | Crofton, MD 21114-1864 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 03/11/2014 |