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Individual

BRYAN JOHN WODASKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS OTRL CHT

Contact information

Practice address
200 GLENN STREET, STE 200, CUMBERLAND, MD 21502
(301) 759-4263
(301) 759-4461
Mailing address
PO BOX 1517, CUMBERLAND, MD 21501-1517
(301) 759-6317
(301) 759-4461

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
03241
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0159766000
WV
Enumeration date
08/04/2006
Last updated
03/27/2008
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