| NPI | 1417118407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORRIE POWELL Credentialing 301-695-8346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MD A1422R) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2024-12-03 |