Organization
PEDIATRIC MOBILITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LYNN MAHER PT MSPT (PHYSICAL THERAPIST OWNER)
(410) 638-0973
Entity
Organization
Contact information
Practice address
402 POPLAR GROVE PL, BEL AIR, MD 21014-2768
(410) 638-0973
(410) 727-2186
Mailing address
402 POPLAR GROVE PL, BEL AIR, MD 21014-2768
(410) 638-0973
(410) 727-2186
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
20049
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18KB
BLUE CROSS BLUE SHIELD
MD
01
—
51490001
BLUE CHOICE
MD
01
—
704159
UNITED HEALTHCARE
MD
01
—
7581819
AETNA
MD
Enumeration date
03/27/2007
Last updated
08/22/2020
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