Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 24888 | MD |
NPI | 1003210949 |
---|---|
Provider Name | Manjula Ramachandran |
First Address | Baltimore, MD 21209-1852 |
Second Address | Lutherville Timonium, MD 21093-3643 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2014 |
Last Update Date | 21/10/2014 |