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Individual

EBENEZER RIVERSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
20410 OBSERVATION DR STE 205, GERMANTOWN, MD 20876-6422
(301) 528-8096
Mailing address
201 RUSSELL AVE, GAITHERSBURG, MD 20877-2800

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
29079
MD

Other

Enumeration date
08/08/2022
Last updated
08/19/2023
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