Provider Demographics
NPI:1821134982
Name:SHRAGER, TODD JASON (MPT, ATC)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:JASON
Last Name:SHRAGER
Suffix:
Gender:M
Credentials:MPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1585 SULPHUR SPRING RD
Mailing Address - Street 2:SUITE #110
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-2569
Mailing Address - Country:US
Mailing Address - Phone:410-247-1100
Mailing Address - Fax:410-247-5740
Practice Address - Street 1:1585 SULPHUR SPRING RD
Practice Address - Street 2:SUITE #110
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-2569
Practice Address - Country:US
Practice Address - Phone:410-247-1100
Practice Address - Fax:410-247-5740
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD20268225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist