BACKPACK MEDICAL GROUP OF KS ASSOCIATION

ELKRIDGE, MD
NPI1275361297
Entity TypeOrganization
Authorized ContactDUKE RUKTANONCHAI
President
630-306-4394
Organization Subpart ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
Additional Taxonomies101Y00000X Counselor
103T00000X Psychologist
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry
Enumeration Date2024-07-22
Last Update Date2024-11-11
Business Address
BACKPACK MEDICAL GROUP OF KS ASSOCIATION
6655 SANTA BARBARA RD UNIT 8574
ELKRIDGE, MD 21075-7523
Phone number: 630-306-4394
Mailing Address
BACKPACK MEDICAL GROUP OF KS ASSOCIATION
6655 SANTA BARBARA RD UNIT 8574
ELKRIDGE, MD 21075-7523
Phone number: