| NPI | 1366640120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEEANN NELSON Owner 410-392-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 17180) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2019-06-11 |