Individual
MR. RICK NELSON PROTHERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
807A S UNION AVE, HAVRE DE GRACE, MD 21078-3610
(410) 939-2262
(410) 939-7119
Mailing address
807A S UNION AVE, HAVRE DE GRACE, MD 21078-3610
(410) 939-2262
(410) 939-7119
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
14518
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
391101200
—
MD
01
—
650020355
RAILROAD MEDICARE
MD
Enumeration date
07/26/2005
Last updated
09/23/2011
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