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Organization
EGONUS BALTIMORE PRO THERAPY AND REHABILITATION PA
Active
Organization
EGONUS BALTIMORE PRO THERAPY AND REHABILITATION PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INNOCENT EGONU (OWNER)
(443) 473-9747
Entity
Organization
Contact information
Practice address
416 EASTERN BLVD, BALTIMORE, MD 21221-6714
(410) 238-2636
(410) 238-2601
Mailing address
416 EASTERN BLVD, BALTIMORE, MD 21221-6714
(410) 238-2636
(410) 238-2601
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
NULL
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
05/13/2015
Last updated
12/05/2022
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