| NPI | 1083022974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD PATTEE Physical Therapy Director 410-884-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MD A00308) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: NJ 25MT00193100) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-07-24 |