Individual
CARRIE DEPETRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
727 BAYARD RD, LOTHIAN, MD 20711-9607
(410) 703-1832
Mailing address
727 BAYARD RD, LOTHIAN, MD 20711-9607
(410) 703-1832
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A3864
MD
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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