| NPI | 1255323242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWEN D STAMPER Owner 301-963-3639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MD 14685) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 14685) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2008-04-01 |