Individual
KRISTA MARIE MAHANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1450 FURNACE AVE, GLEN BURNIE, MD 21060-7002
(410) 222-6911
Mailing address
827 S CHARLES ST, BALTIMORE, MD 21230-3938
(410) 962-5344
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19318
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5553
—
MD
Enumeration date
03/07/2007
Last updated
07/08/2007
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