| NPI | 1043808124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA FOWLER Owner 301-908-4228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 208VP0000X |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2024-10-18 |