Provider Demographics
NPI:1659579183
Name:KERBER, MICHELLE ANN (PT, MS)
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:ANN
Last Name:KERBER
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 SONNE DR
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7120
Mailing Address - Country:US
Mailing Address - Phone:410-971-8586
Mailing Address - Fax:443-949-0075
Practice Address - Street 1:701 SONNE DR
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7120
Practice Address - Country:US
Practice Address - Phone:410-971-8586
Practice Address - Fax:443-949-0075
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18335225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist