Provider Demographics
NPI:1508095944
Name:RICHWINE, PAULA MARIE (PT, MPT, DPT)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:MARIE
Last Name:RICHWINE
Suffix:
Gender:F
Credentials:PT, MPT, DPT
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:MARIE
Other - Last Name:WIRTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 179
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-0179
Mailing Address - Country:US
Mailing Address - Phone:410-838-6808
Mailing Address - Fax:410-838-2511
Practice Address - Street 1:2304 E CHURCHVILLE RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-1721
Practice Address - Country:US
Practice Address - Phone:410-734-6556
Practice Address - Fax:410-734-6557
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22931225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist