Healthcare Provider Details

I. General information

NPI: 1952371882
Provider Name (Legal Business Name): DOMSER & PLUMMER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 BALTIMORE BLVD
WESTMINSTER MD
21157-6105
US

IV. Provider business mailing address

731 BALTIMORE BLVD
WESTMINSTER MD
21157-6105
US

V. Phone/Fax

Practice location:
  • Phone: 410-848-8628
  • Fax: 410-848-3909
Mailing address:
  • Phone: 410-848-8628
  • Fax: 410-848-3909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number16859
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17083
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15216
License Number StateMD

VIII. Authorized Official

Name: PATRICIA DOMSER
Title or Position: PRESIDENT
Credential: PT, CHT
Phone: 410-848-8628