Individual
GERALD WIXTED III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
9110 PHILADELPHIA RD, SUITE 104, ROSEDALE, MD 21237-4301
(410) 686-8922
(410) 686-8923
Mailing address
9110 PHILADELPHIA RD, SUITE 104, ROSEDALE, MD 21237-4301
(410) 686-8922
(410) 686-8923
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
25064
MD
Other
Enumeration date
07/03/2014
Last updated
10/20/2016
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