Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A5359 | MD |
NPI | 1013599018 |
---|---|
Provider Name | Rachel Mcintyre |
First Address | Columbia, MD 21044-3631 |
Second Address | Olney, MD 20832-1384 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2021 |
Last Update Date | 28/04/2021 |