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NPI Code Detail

MEDICARE: WILMA A COROS DPT

MEDICARE: WILMA A COROS DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist21458MD
2225100000XPhysical Therapist008156GA

General Provider Information

NPI Number : 1790901064
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILMA A COROS DPT
Provider Business Mailing Address
First Line : 126 MCCLELLAN DR
Second Line :
City : FREDERICK
State : MD
Zip : 21702-5502
Country : US
Telephone Number : 301-663-7826
Fax Number :
Provider Business Practice Location Address
First Line : 6707 DEMOCRACY BLVD STE 504
Second Line :
City : BETHESDA
State : MD
Zip : 20817-1166
Country : US
Telephone Number : 301-637-8712
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2007
Last Update Date : 12/01/2025

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Directions to “ WILMA A COROS DPT” Practice Location

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