Individual
THEA KOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 MERIDIAN LN, TOWSON, MD 21286-5205
(443) 413-1904
Mailing address
202 MERIDIAN LN, TOWSON, MD 21286-5205
(443) 413-1904
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R184684
MD
Other
Enumeration date
02/09/2015
Last updated
10/14/2015
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