MEDICARE: MRS. JOYCE L COADY PTA

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
1	225200000X	Physical Therapy Assistant	A2064	MD

General Provider Information

NPI Number	:	1811071996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOYCE L COADY PTA

Provider Business Mailing Address
First Line	:	1431 HEAPS RD
Second Line	:
City	:	WHITEFORD
State	:	MD
Zip	:	21160-1405
Country	:	US
Telephone Number	:	410-638-0700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2217 COMMERCE RD
Second Line	:
City	:	FOREST HILL
State	:	MD
Zip	:	21050-2565
Country	:	US
Telephone Number	:	410-638-0700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/08/2007

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