Individual
LUIS GUILLERMO CARMONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
16 FUSTING AVE, CATONSVILLE, MD 21228-4413
(410) 747-1800
Mailing address
4918 ORCHARD DR, ELLICOTT CITY, MD 21043-6725
(410) 203-0424
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1890
MD
225200000X
Physical Therapy Assistant
A1890
NY
Other
Enumeration date
11/12/2013
Last updated
11/12/2013
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