Individual
MRS. JACKIE DENISE PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8748 LACKAWANNA AVE, BALTIMORE, MD 21234-3506
(410) 661-5955
Mailing address
8748 LACKAWANNA AVE, BALTIMORE, MD 21234-3506
(410) 661-5955
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2761
MD
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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