| NPI | 1073778122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE PETER BULLEN Owner 202-966-9280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: DC CH21732) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2008-07-28 |