Individual
LYDIA ELIZABETH PAVELKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
23000 MOAKLEY ST, SUITE 101, LEONARDTOWN, MD 20650-2915
(301) 475-5830
(301) 475-6507
Mailing address
23000 MOAKLEY ST, SUITE 101, LEONARDTOWN, MD 20650-2915
(301) 475-5830
(301) 475-6507
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23256
MD
225100000X
Physical Therapist
33845
CA
225100000X
Physical Therapist
PTH5530
AL
225100000X
Physical Therapist
PTH7148
AL
Other
Enumeration date
03/13/2008
Last updated
08/10/2016
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