Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT-01174L | PA |
NPI | 1023075546 |
---|---|
Provider Name | Maria N Bogdanova |
First Address | West Chester, PA 19382-8483 |
Second Address | Thorndale, PA 19372-1134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 08/07/2007 |