Individual
IVANKA JASMINE TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11803 MEADOWLAND DR, BOWIE, MD 20720-3580
(240) 780-1018
Mailing address
11803 MEADOWLAND DR, BOWIE, MD 20720-3580
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
30204
MD
Other
Enumeration date
11/12/2024
Last updated
11/12/2024
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