Provider Demographics
NPI:1235338914
Name:NATHER, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:NATHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 PULASKI HWY
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701
Mailing Address - Country:US
Mailing Address - Phone:302-834-1550
Mailing Address - Fax:302-834-1549
Practice Address - Street 1:1651-53 PULASKI HWY
Practice Address - Street 2:SALEM CENTER
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701
Practice Address - Country:US
Practice Address - Phone:302-834-1550
Practice Address - Fax:302-834-1549
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ10002237225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist