| NPI | 1104253160 |
|---|---|
| Doing Business As | IMAGE RECOVERY CENTER AT UPPER CHESAPEAKE |
| Entity Type | Organization |
| Authorized Contact | EDWARD JEROME KELLY CEO 410-560-0614 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2013-10-03 |