Individual
MATHIAS BODDICKER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14435 CHERRY LANE CT, SUITE NUMBER 100, LAUREL, MD 20707-4959
(301) 776-3665
Mailing address
14435 CHERRY LANE CT, LAUREL, MD 20707-4959
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
25618
MD
Other
Enumeration date
03/29/2016
Last updated
03/29/2016
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