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General NPI Number Information
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NPI Number | 1740647262
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Entity Type | Individual
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Provider Name | DARREN JOSEPH DPT
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Gender | Male
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Dates
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Enumeration Date | 01/28/2016
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 9030 STATE ROUTE 108 STE B
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City | COLUMBIA
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State | MD
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Zip | 21045-1990
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Country | US
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Telephone | 410-989-3833
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Fax |
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Provider Business Mailing Address
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Address Line | 9030 STATE ROUTE 108 STE B
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City | COLUMBIA
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State | MD
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Zip | 21045-1990
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Country | US
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Telephone | 410-989-3833
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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 | 24779
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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 | 05012351A
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License Number State | IN
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