| NPI | 1417987181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLE CHEATHAM Office Manager 410-583-0160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-11-05 |