Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A1356 | MD |
NPI | 1013038181 |
---|---|
Provider Name | Lisa A Walther |
First Address | Baltimore, MD 21213-3939 |
Second Address | Baltimore, MD 21205-1832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |