Individual
KYAH ROUNDTREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2001 MEDICAL PKWY, ANNAPOLIS, MD 21401-3773
(443) 481-1140
Mailing address
1332 CAPE ST CLAIRE RD, ANNAPOLIS, MD 21409-5216
(443) 481-1140
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188727
MARYLAND STATE BOARD OF PHYSICAL THERAPY EXAMINERS
MD
Enumeration date
03/06/2019
Last updated
06/19/2020
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