Individual
JONATHAN T STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2200 KERNAN DR, BALTIMORE, MD 21207-6665
(410) 448-6323
(410) 448-6338
Mailing address
2200 KERNAN DR, BALTIMORE, MD 21207-6665
(410) 448-6323
(410) 448-6338
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
22643
MD
Other
Enumeration date
04/15/2010
Last updated
04/15/2010
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