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NPI Code Detail

MEDICARE: MRS. LAURA ANNE GLASS PTA

MEDICARE: MRS. LAURA ANNE GLASS 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
1225200000XPhysical Therapy AssistantA2485MD

General Provider Information

NPI Number : 1952473878
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA ANNE GLASS PTA
Provider Business Mailing Address
First Line : 918 HOLLIS CT
Second Line :
City : LUSBY
State : MD
Zip : 20657-3609
Country : US
Telephone Number : 410-326-1059
Fax Number :
Provider Business Practice Location Address
First Line : 13325 DOWELL ROAD
Second Line :
City : SOLOMONS
State : MD
Zip : 20688-3004
Country : US
Telephone Number : 410-326-2510
Fax Number : 410-326-2510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 07/08/2007

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