Individual
IHSAN ABDUL JABBAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
515 BRIGHTFIELD RD, LUTHERVILLE, MD 21093-3643
(410) 832-2399
Mailing address
1705 MCCULLOH ST, BALTIMORE, MD 21217-3435
(410) 952-4235
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2689
MD
Other
Enumeration date
04/24/2014
Last updated
04/24/2014
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