Individual
JEREMY WALLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
801 N BROADWAY, BALTIMORE, MD 21205-1424
(443) 923-9468
Mailing address
801 N BROADWAY, BALTIMORE, MD 21205-1424
(443) 923-9468
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
25484
MD
Other
Enumeration date
06/24/2015
Last updated
07/25/2023
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