Individual
MARK OLIVER VICERRA BORJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
700 W 40TH ST, BALTIMORE, MD 21211-2140
(410) 235-8660
Mailing address
3632 WILLOW ST, HAMPSTEAD, MD 21074-1890
(410) 382-8628
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
A4265
MD
225X00000X
Occupational Therapist
Primary
09257
MD
Other
Enumeration date
04/20/2021
Last updated
04/20/2021
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