Individual
RITA M BASISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA ,
Contact information
Practice address
40900 MERCHANT LANE, BLAIR BUILDING SUITE 202, LEONARDTOWN, MD 20650
(301) 997-1155
Mailing address
PO BOX 2327, LEONARDTOWN, MD 20650
(301) 997-1155
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2221
MD
Other
Enumeration date
08/15/2007
Last updated
08/15/2007
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