| NPI | 1174739577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRONE ALONZO CHAPMAN Billing & Revenue Mgr. 443-739-3253 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QS1000X Clinic/Center Student Health |
| Additional Taxonomies | 261QP0905X Clinic/Center Public Health, State or Local |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2023-10-04 |