| NPI | 1043663206 |
|---|---|
| Doing Business As | ACTIVE LIFE PT |
| Entity Type | Organization |
| Authorized Contact | MICHAEL D WAH Owner 410-227-1417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2016-07-22 |