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Individual

MRS. JENNAFER ASHLEY TRYON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
314 FRANKLIN AVE STE 405, BERLIN, MD 21811-1263
(410) 641-2900
(410) 641-2914
Mailing address
314 FRANKLIN AVE STE 405, BERLIN, MD 21811-1263
(410) 641-2900
(410) 641-2914

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
24279
MD
225100000X
Physical Therapist
Primary
J1-0002934
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000220726
DE
01
086513
MEDICARE
DE
01
216538
MEDICARE UNSPEC
MD
05
435138000
MD
Enumeration date
11/01/2012
Last updated
08/31/2022
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