Organization
M ROTH PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY RENNA THOMAS (CREDENTIALING MANAGER)
(410) 663-4036
Entity
Organization
Contact information
Practice address
6503 HAL CT, BALTIMORE, MD 21209-2623
(443) 762-5530
Mailing address
6503 HAL CT, BALTIMORE, MD 21209-2623
(443) 762-5530
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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