Individual
MRS. CARA LARKIN LEWIS-ROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
9029 BRADLEY BLVD, POTOMAC, MD 20854-4604
(301) 365-0955
Mailing address
9029 BRADLEY BLVD, POTOMAC, MD 20854-4604
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A0001017
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A0001017
ATHLETIC TRAINING LICENSE
MD
Enumeration date
04/09/2018
Last updated
04/09/2018
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