Healthcare Provider Details

I. General information

NPI: 1952422206
Provider Name (Legal Business Name): CHRISTINE MARGARET MCCAULEY MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 05/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8165 CYPRUS CEDAR LN STE 205
ELLICOTT CITY MD
21043-5565
US

IV. Provider business mailing address

5210 NEW PROSPECT CT
ELLICOTT CITY MD
21043-6679
US

V. Phone/Fax

Practice location:
  • Phone: 410-799-0818
  • Fax: 410-799-2653
Mailing address:
  • Phone: 410-461-1506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number19440
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number19440
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: