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General NPI Number Information
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NPI Number | 1053660845
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Entity Type | Individual
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Provider Name | MARA JEANINE DRIGGERS DPT
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Gender | Female
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 12/12/2016
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Provider Practice Location Address
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Address Line | 232 MITCHELL ST
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City | MILLSBORO
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State | DE
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Zip | 19966-9412
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Country | US
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Telephone | 302-934-5830
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Fax |
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Provider Business Mailing Address
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Address Line | 31326 FOUNDERS AVE
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City | SELBYVILLE
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State | DE
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Zip | 19975-3728
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Country | US
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Telephone | 410-952-3114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 24157
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6447
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | J1-0002902
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License Number State | DE
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