Individual
MRS. DANIELLE LATRICIA GOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
606 CANNON STREET, CHESTERTOWN, MD 21620
(410) 810-2957
Mailing address
606 CANNON STREET, CHESTERTOWN, MD 21620
(410) 810-2957
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
A2827
MD
261QP2000X
Physical Therapy Clinic/Center
J2-0000642
DE
Other
Enumeration date
03/11/2008
Last updated
03/11/2008
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