| NPI | 1003694639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMEAN WILLIAM FREAS CEO 410-571-2946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| 208100000X Physical Medicine & Rehabilitation | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2023-09-15 |
| Last Update Date | 2023-09-15 |