| NPI | 1023484060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE MARIE SORETH Dep Director, Special Medical Prog 240-402-4981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101043387) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2015-08-13 |