Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 28110 | MD |
NPI | 1043814429 |
---|---|
Provider Name | Thomas Mccabe |
First Address | Gaithersburg, MD 20877 |
Second Address | Gaithersburg, MD 20877 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2020 |
Last Update Date | 25/11/2020 |