Individual
JENNA NIETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11070 CATHELL RD STE 7, BERLIN, MD 21811-9344
(410) 208-3630
Mailing address
PO BOX 392573, PITTSBURGH, PA 15251-9573
(410) 208-3630
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
27673
MD
225100000X
Physical Therapist
Primary
J1-0004168
DE
Other
Enumeration date
11/13/2019
Last updated
10/08/2024
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