Individual
LISA DOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
197 THOMAS JOHNSON DR STE B, FREDERICK, MD 21702-4314
(301) 662-1997
Mailing address
15 CHRISTIANS DR, HANOVER, PA 17331-8467
(443) 570-7302
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
A2166
MD
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A2166
MARYLAND PTA LICENSE
MD
Enumeration date
11/29/2018
Last updated
11/29/2018
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