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General NPI Number Information
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NPI Number | 1285904854
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Entity Type | Organization
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Legal Business Name | KAREN N. BONSACK PT LLC
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 09/14/2012
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Provider Practice Location Address
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Address Line | 7 ABERDEEN PLAZA
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City | ABERDEEN
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State | MD
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Zip | 21001-3817
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Country | US
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Telephone | 410-272-7770
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Fax | 410-272-7771
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Provider Business Mailing Address
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Address Line | 7 ABERDEEN PLAZA
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City | ABERDEEN
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State | MD
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Zip | 21001-3817
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Country | US
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Telephone | 410-272-7770
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Fax | 410-272-7771
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Authorized Official
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Title or Position | OWNER
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Name | MS. KAREN NANCY BONSACK
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Credential | P.T.
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Telephone | 410-272-7770
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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 | 15890
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License Number State | MD
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