| NPI | 1447657507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANTHONY YOST General Counsel 301-864-2333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse |
| 213E00000X Podiatrist | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2014-12-09 |