Individual
LISA MARIE KANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
10540 YORK RD, SUITE H, COCKEYSVILLE, MD 21030-2300
(410) 628-0520
(410) 628-0542
Mailing address
10540 YORK RD, SUITE H, COCKEYSVILLE, MD 21030-2300
(410) 628-0520
(410) 628-0542
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23752
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11983606
CAQH
—
Enumeration date
08/27/2007
Last updated
05/23/2012
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