Provider Demographics
NPI:1598087819
Name:CONTRACTOR, BELA
Entity Type:Individual
Prefix:
First Name:BELA
Middle Name:
Last Name:CONTRACTOR
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 1:9024 DUNLOGGIN RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-5206
Mailing Address - Country:US
Mailing Address - Phone:410-988-5774
Mailing Address - Fax:410-988-5774
Practice Address - Street 1:9024 DUNLOGGIN RD
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-5206
Practice Address - Country:US
Practice Address - Phone:410-988-5774
Practice Address - Fax:410-988-5774
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22408225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist