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General NPI Number Information
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NPI Number | 1174699698
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL HEALTH STAFFING OF MARYLAND
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11350 MCCORMICK RD EP 1 SUITE 503
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City | HUNT VALLEY
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State | MD
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Zip | 21031-1002
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Country | US
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Telephone | 410-771-6868
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Fax | 410-771-8444
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Provider Business Mailing Address
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Address Line | 11350 MCCORMICK RD EP 1 SUITE 503
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City | HUNT VALLEY
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State | MD
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Zip | 21031-1002
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Country | US
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Telephone | 410-771-6868
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Fax | 410-771-8444
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MS. KIMBERLY LOUISE LOCATI-BOUCHER
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Credential | OTR
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Telephone | 410-771-6868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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