Provider Demographics
NPI:1689825960
Name:GROTHE, BRITA DAWN (DPT)
Entity Type:Individual
Prefix:
First Name:BRITA
Middle Name:DAWN
Last Name:GROTHE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10062 COTTONMILL LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1340
Mailing Address - Country:US
Mailing Address - Phone:240-605-2517
Mailing Address - Fax:
Practice Address - Street 1:10062 COTTONMILL LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1340
Practice Address - Country:US
Practice Address - Phone:240-605-2517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21929225100000X
WA60041958225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist