Provider Demographics
NPI:1902826357
Name:ZONIS, BETTY JO (PT)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:JO
Last Name:ZONIS
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 1:9736 LOCK TENDER LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:MD
Mailing Address - Zip Code:21795-4065
Mailing Address - Country:US
Mailing Address - Phone:301-223-6868
Mailing Address - Fax:
Practice Address - Street 1:17 WESTERN MARYLAND PKWY
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5146
Practice Address - Country:US
Practice Address - Phone:301-797-9240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18974225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00276374OtherRR MEDICARE
MD61181602OtherMD BLUE SHIELD TRADITONAL
MDW2660009OtherMD BLUE SHIELD REGIONAL
MDW2660009OtherMD BLUE SHIELD REGIONAL
MD602LN179Medicare PIN