Provider Demographics
NPI:1174967616
Name:BABRA, DEVINDER SINGH (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:DEVINDER
Middle Name:SINGH
Last Name:BABRA
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 E RIDGEVILLE BLVD
Mailing Address - Street 2:247
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-5201
Mailing Address - Country:US
Mailing Address - Phone:240-491-7134
Mailing Address - Fax:
Practice Address - Street 1:327 E RIDGEVILLE BLVD
Practice Address - Street 2:247
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-5201
Practice Address - Country:US
Practice Address - Phone:240-491-7134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-27
Last Update Date:2013-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMT1050225700000X
VA0019007081225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist