Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 16298 | MD |
Y | 2251X0800X | Physical Therapist - Orthopedic | 16298 | MD |
NPI | 1417175704 |
---|---|
Provider Name | Joyce H Mady |
First Address | Ellicott City, MD 21042-7766 |
Second Address | Ellicott City, MD 21042-7766 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 09/12/2008 |