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General NPI Number Information
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NPI Number | 1063924942
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Entity Type | Individual
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Provider Name | CASEY L FITZPATRICK PT
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Gender | Female
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Dates
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Enumeration Date | 10/31/2017
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 1400 NALLEY TER
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City | LANDOVER
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State | MD
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Zip | 20785-4434
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Country | US
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Telephone | 443-764-7535
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Fax |
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Provider Business Mailing Address
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Address Line | 501 NORTON LN
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City | ARNOLD
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State | MD
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Zip | 21012-2359
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Country | US
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Telephone | 443-883-0748
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 27563
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License Number State | MD
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