| NPI | 1356997530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L DAVIS Director Of Sport Medicine 240-670-0081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| 207PS0010X Emergency Medicine Sports Medicine | |
| 2081S0010X Physical Medicine & Rehabilitation Sports Medicine | |
| 2083S0010X Preventive Medicine Sports Medicine | |
| 2251S0007X Physical Therapist Sports | |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2019-08-14 |