MARK OLIVER VICERRA BORJA

BALTIMORE, MD
NPI1831770882
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: MD  09257)
Additional Taxonomies225200000X Physical Therapy Assistant
(Licence: MD  A4265)
Enumeration Date2021-04-20
Last Update Date2021-04-20
Business Address
MARK OLIVER VICERRA BORJA OTR/L
700 W 40TH ST
BALTIMORE, MD 21211-2140
Phone number: 410-235-8660
Mailing Address
MARK OLIVER VICERRA BORJA OTR/L
3632 WILLOW ST
HAMPSTEAD, MD 21074-1890
Phone number: 410-382-8628