Provider Demographics
NPI:1558485409
Name:WORTON, JOANN HOPKINS (PT)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:HOPKINS
Last Name:WORTON
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 1:347 AILSA DR
Mailing Address - Street 2:
Mailing Address - City:RISING SUN
Mailing Address - State:MD
Mailing Address - Zip Code:21911-2558
Mailing Address - Country:US
Mailing Address - Phone:443-553-8898
Mailing Address - Fax:
Practice Address - Street 1:347 AILSA DR
Practice Address - Street 2:
Practice Address - City:RISING SUN
Practice Address - State:MD
Practice Address - Zip Code:21911-2558
Practice Address - Country:US
Practice Address - Phone:443-553-8898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-00003912251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics