| NPI | 1376362855 |
|---|---|
| Doing Business As | JHCP-14955 SHADY GROVE ROAD STE 100 |
| Entity Type | Organization |
| Authorized Contact | STEVEN KRAVET AO 410-933-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2024-10-10 |
| Last Update Date | 2024-10-10 |