| NPI | 1013739747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MINH PHAN Owner 410-870-9167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2024-10-24 |
| Last Update Date | 2024-10-30 |