NPI | 1174977540 |
---|---|
Doing Business As | SEVERNA PARK CENTER |
Entity Type | Organization |
Authorized Contact | MICHAEL T. BERG Assistant Secretary 505-468-4752 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 02019) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 02019) |
Enumeration Date | 2016-04-21 |
Last Update Date | 2017-09-07 |