Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 17480 | MD |
N | 2251S0007X | Physical Therapist - Sports | 17480 | MD |
N | 2251X0800X | Physical Therapist - Orthopedic | 17480 | MD |
NPI | 1164503546 |
---|---|
Provider Name | Jeffrey Alan Torockio |
First Address | Eldersburg, MD 21784-5960 |
Second Address | Marriottsville, MD 21104-1515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 20/04/2021 |