Healthcare Provider Details

I. General information

NPI: 1558783381
Provider Name (Legal Business Name): PATRICIA HERFORD DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA RICHARDSON DPT

II. Dates (important events)

Enumeration Date: 01/14/2014
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3233 SUPERIOR LN STE B4
BOWIE MD
20715-1940
US

IV. Provider business mailing address

3233 SUPERIOR LN STE B4
BOWIE MD
20715-1940
US

V. Phone/Fax

Practice location:
  • Phone: 443-848-0372
  • Fax:
Mailing address:
  • Phone: 443-848-0372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number24868
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: