| NPI | 1376711796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARBY M. BOLT President 240-357-5590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: MD SO1649) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2011-11-09 |