| NPI | 1407277916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONIA ROSS Billing Manager 410-887-0684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local (Licence: MD R135730) |
| Enumeration Date | 2013-12-31 |
| Last Update Date | 2025-07-08 |