| NPI | 1164908711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLON COHEN Owner 202-544-4478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 363L00000X Nurse Practitioner (Licence: DC RN1036098) | |
| 363L00000X Nurse Practitioner (Licence: DC RN1015652) | |
| 111N00000X Chiropractor (Licence: DC CH30028) | |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2020-08-06 |