Individual
LARISA MATOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4000 OLD COURT RD STE 100, PIKESVILLE, MD 21208-2891
(410) 415-0005
Mailing address
4000 OLD COURT RD STE 100, PIKESVILLE, MD 21208-2891
(410) 415-0005
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A1779
MD
Other
Enumeration date
02/07/2018
Last updated
09/07/2023
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