| NPI | 1336515519 |
|---|---|
| Other Name | GOVERNOR'S WELLMOBILE PROGRAM |
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIE ANTOL Program Director 410-706-5395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2015-08-11 |