Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 21887 | MD |
N | 2251X0800X | Physical Therapist - Orthopedic | 21887 | MD |
NPI | 1003869835 |
---|---|
Provider Name | Mary P Miller |
First Address | Baltimore, MD 21231-3401 |
Second Address | Baltimore, MD 21231-3401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 17/12/2021 |