Individual
KENNETH J CRIVELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
3104 LORD BALTIMORE DR, BALTIMORE, MD 21244-2898
(410) 298-0990
(410) 298-0871
Mailing address
10364 TUSCANY RD, ELLICOTT CITY, MD 21042-2154
(410) 465-2241
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14734
MD
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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