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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MONICA MORALES PT (SOLE PROPRIETOR)
(410) 531-7558
Entity
Organization

Contact information

Practice address
3130 EVERGREEN WAY, ELLICOTT CITY, MD 21042-1024
(410) 531-7558
(410) 531-7558
Mailing address
3130 EVERGREEN WAY, ELLICOTT CITY, MD 21042-1024
(410) 531-7558
(410) 531-7558

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
15420
MD
225100000X
Physical Therapist
Primary
16690
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
KAF3
BCBS
MD
Enumeration date
02/20/2007
Last updated
07/16/2008
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