Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A1949 | MD |
NPI | 1023149226 |
---|---|
Provider Name | Mr. Timothy Strauch |
First Address | Baltimore, MD 21234-2635 |
Second Address | Baltimore, MD 21287-0005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 08/07/2007 |