| NPI | 1467513978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED S GOLDSTEIN Owner 410-381-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 19690) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: MD 19690) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MD 19690) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2008-12-19 |