| Miss Taila Dane De Souza, DPT | |
|
4062 Rustico Rd, Middle River, MD 21220-2342 | |
| (410) 335-7898 | |
| Not Available |
| Full Name | Miss Taila Dane De Souza |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 4062 Rustico Rd, Middle River, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780016303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 24568 (Maryland) | Primary |
| Provider Name | Salus Capital Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1568859478 PECOS PAC ID: 6103131198 Enrollment ID: O20151008000415 |
| Mailing Address | Practice Location Address |
|---|---|
| Miss Taila Dane De Souza, DPT 4062 Rustico Rd, Middle River, MD 21220-2342 Ph: (410) 335-7898 | Miss Taila Dane De Souza, DPT 4062 Rustico Rd, Middle River, MD 21220-2342 Ph: (410) 335-7898 |
Sonali Shah, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1364 Martin Blvd Ste 5, Middle River, MD 21220 Phone: 410-686-3600 | |
Maggie Matassa, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 425 Williams Ct Ste 116, Middle River, MD 21220 Phone: 443-963-3234 | |
Shawna Rae Sprout, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1364 Martin Blvd Ste 5, Middle River, MD 21220 Phone: 410-686-3600 |