Individual
DEBORA KIESSEL MEDLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
6500 THAYER CTR, OAKLAND, MD 21550-1116
(301) 334-1863
(301) 334-5835
Mailing address
6500 THAYER CTR, OAKLAND, MD 21550-1116
(301) 334-1863
(301) 334-5835
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
002043
WV
225100000X
Physical Therapist
Primary
19741
MD
225100000X
Physical Therapist
PT016587
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186300200
—
MD
Enumeration date
03/15/2007
Last updated
11/07/2012
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