Provider Demographics
NPI:1497921399
Name:LIM, NANCY (PT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 RITCHIE HWY
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-4127
Mailing Address - Country:US
Mailing Address - Phone:410-544-0773
Mailing Address - Fax:410-544-0774
Practice Address - Street 1:844 RITCHIE HWY
Practice Address - Street 2:SUITE 208
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4127
Practice Address - Country:US
Practice Address - Phone:410-544-0773
Practice Address - Fax:410-544-0774
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15449225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist