Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 20927 | MD |
NPI | 1003250325 |
---|---|
Provider Name | Kristina Ling |
First Address | Laurel, MD 20708-4213 |
Second Address | Laurel, MD 20708-4213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2013 |
Last Update Date | 18/04/2013 |