| NPI | 1306153887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOWANDA THORNTON Medical Secretary 410-583-7979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MD D0034988) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2010-09-07 |