Individual
JAIMIE FANGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
617 WOODHURST WAY, BALTIMORE, MD 21228-4127
(443) 841-2211
Mailing address
617 WOODHURST WAY, BALTIMORE, MD 21228-4127
(443) 841-2211
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9281
MA
225200000X
Physical Therapy Assistant
A3269
MD
Other
Enumeration date
11/01/2016
Last updated
05/04/2021
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