Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A3984 | MD |
NPI | 1003200411 |
---|---|
Provider Name | Ms. Monica Musyt |
First Address | Riva, MD 21140-1205 |
Second Address | Annapolis, MD 21409-5679 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2015 |
Last Update Date | 24/03/2015 |