| NPI | 1235616475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MARTIN Owner 240-671-1747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD R182264) |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2022-12-19 |