Stacey Marie Davis, PTA, CLT

Individual provider Active NPI Physical Therapy Assistant · Dundalk, MD

NPI 1962513655 · NPPES record last updated Feb 16, 2024

Key facts

NPI
1962513655
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
A3045 (MD)
Practice address
1576 Merritt Blvd Ste 7
Dundalk, MD 21222-2114
Phone
(410) 650-2145
Fax
(410) 282-5955
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A3045MDMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A3045 MD Yes

Addresses

Primary practice location

1576 Merritt Blvd Ste 7
Dundalk, MD 21222-2114

Mailing address

1576 Merritt Blvd Ste 7
Dundalk, MD 21222-2114
Phone (410) 650-2145

Other providers in Dundalk, MD

All providers in Dundalk, MD · Physical Therapy Assistant in Maryland

Sources for this page

Verify at the official NPI Registry.