| NPI | 1164584488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN RAMON GARCIA Clinic Director 410-955-3213 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 229N00000X Anaplastologist |
| Additional Taxonomies | 156FX1700X Technician/Technologist Ocularist |
| 224900000X Mastectomy Fitter | |
| 224L00000X Pedorthist | |
| 225000000X Orthotic Fitter | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2025-08-21 |