| Doctor Name: | MARY EZZEDDINE |
| NPI Number: | 1194157115 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 2305209477 |
| Business Practice Address: | 4251 Legion Rd Ste 107 Hope Mills, NC - 283486200 |
| Business Phone Number: | 9104290600 |
| Business Fax Number: | 9104290602 |
| Mailing Address: | 7310 Ritchie Hwy, Ste 500 GLEN BURNIE |
| State: | MD |
| Postal Code: | 21061 |
| Phone Number: | 4107664047 |
| Fax Number: | 4107664049 |
| NPI Enumeration Date: | 08/01/2013 |
| NPI Last Update Date: | 08/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2305209477 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |