Individual
MRS. DEBORA DEADERICK BROCKINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2225 OLD EMMORTON ROAD, SUITE 210, BEL AIR, MD 21015-6123
(410) 515-4900
(410) 515-0777
Mailing address
2225 OLD EMMORTON RD STE 210, BEL AIR, MD 21015-6123
(410) 515-4900
(410) 515-0777
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15915
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
419800000
—
MD
Enumeration date
03/02/2007
Last updated
01/30/2019
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