Individual
REGINA RAQUELLE MODZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
102 IRVING ST NW, WASHINGTON, DC 20010-2921
(202) 877-1000
Mailing address
1529 14TH ST NW APT 402, WASHINGTON, DC 20005-3786
(330) 417-3051
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA000181
DC
Other
Enumeration date
02/04/2019
Last updated
02/04/2019
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