Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 27479 | MD |
NPI | 1053970889 |
---|---|
Provider Name | Dr. Caroline Victoria Vink |
First Address | Pikesville, MD 21208-2161 |
Second Address | Odenton, MD 21113-1738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2019 |
Last Update Date | 05/06/2019 |