Organization
MARYLAND REAL LIFE DESIGNS, LLC
Active
Organization
MARYLAND REAL LIFE DESIGNS, LLC
Active
Other names
Real Life Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA YEATER (MEMBER/CFO)
(410) 569-0606
Entity
Organization
Contact information
Practice address
110 WEST RD, SUITE 105, TOWSON, MD 21204-2316
(410) 296-5462
Mailing address
3435 BOX HILL CORPORATE CENTER DR, SUITE D, ABINGDON, MD 21009-1204
(410) 569-0606
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4090110001
MEDICARE PROVIDER NUMBER
—
Enumeration date
09/21/2010
Last updated
01/11/2022
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