| NPI | 1346718699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM BOWDEN Owner 443-820-5751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2018-11-05 |