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Individual

MR. TODD ALAN MISURA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
12010 SMOKETREE RD, POTOMAC, MD 20854-3463
(301) 741-1325
Mailing address
12010 SMOKETREE RD, POTOMAC, MD 20854-3463
(301) 741-1325

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
0119004220
VA
225XP0200X
Pediatric Occupational Therapist
Primary
05695
MD
225XP0200X
Pediatric Occupational Therapist
OT010000394
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
225XP0200X
INDEPENDENCE BLUE CROSS
Enumeration date
03/24/2009
Last updated
03/24/2009
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