Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 22529 | MD |
NPI | 1174839062 |
---|---|
Provider Name | Miss Ayana Kara Torrence |
First Address | Pikesville, MD 21208-6939 |
Second Address | Randallstown, MD 21133-1018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2010 |
Last Update Date | 30/08/2010 |