| NPI | 1295180487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA WIES Owner 410-913-9829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MD 18331) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |