| NPI | 1013074814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA TANKERLSEY Administrator 410-974-0922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 15619) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |