Individual
MATTHEW DONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1219 WAUGH CHAPEL RD, GAMBRILLS, MD 21054-1608
(904) 451-8334
Mailing address
1467 JUSTIN PL, CROFTON, MD 21114-2122
(904) 451-8334
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4479
MD
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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