Individual
IMANI MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
9501 OLD ANNAPOLIS RD, ELLICOTT CITY, MD 21042-6314
(301) 540-6140
Mailing address
20410 CENTURY BLVD, NRH REGIONAL REHAB - SUITE 215, GERMANTOWN, MD 20874-1186
(301) 540-6140
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
22794
MD
Other
Enumeration date
02/05/2009
Last updated
02/05/2009
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