| NPI | 1124201660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID COHEN Owner 410-292-3134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X (Licence: MD 00384) |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2024-08-15 |