| NPI | 1366552333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS BANKS WETMORE Therapist/Sole Proprietor 410-280-0990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MD 12570) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-07-21 |