Provider Demographics
NPI:1801188164
Name:PRESCOTT, PATRICIA L (PT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:PRESCOTT
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 1:1840 REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1305
Mailing Address - Country:US
Mailing Address - Phone:410-486-0296
Mailing Address - Fax:410-486-0301
Practice Address - Street 1:1840 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-1305
Practice Address - Country:US
Practice Address - Phone:410-486-0296
Practice Address - Fax:410-486-0301
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15673225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist