Individual
MRS. CARISSA KNOUSE COLANGELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, PTA
Contact information
Practice address
2900 S HANOVER ST, SUITE 102, BALTIMORE, MD 21225-1232
(410) 350-8372
Mailing address
431 ELLIS LN, BEL AIR, MD 21014-2620
(717) 870-6377
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A3409
MD
225200000X
Physical Therapy Assistant
TE06693
PA
2255A2300X
Athletic Trainer
RT003411
PA
Other
Enumeration date
06/19/2006
Last updated
08/26/2010
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