Individual
MARY J BANIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
RR 5 BOX 521, KEYSER, WV 26726-9016
(301) 707-3346
(304) 726-4213
Mailing address
RR 5 BOX 521, KEYSER, WV 26726-9016
(301) 707-3346
(304) 726-4213
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1589
WV
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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