Individual
ANNIKA MOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9815 MAIN ST STE 206, DAMASCUS, MD 20872-2099
(301) 253-6761
Mailing address
23824 ROLLING FORK WAY, GAITHERSBURG, MD 20882-2725
(240) 506-2198
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A3815
MD
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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