Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 19563 | MD |
N | 2251C2600X | Cardiopulmonary | 19563 | MD |
N | 2251P0200X | Physical Therapist - Pediatrics | 19563 | MD |
NPI | 1396883369 |
---|---|
Provider Name | Mr. David C Terborg |
First Address | Bel Air, MD 21015-1596 |
Second Address | Leonardtown, MD 20650-2015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 08/05/2014 |