| NPI | 1467969832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHASE LEVAR ISOM Owner/Specialist 443-518-9075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: MD 101749) |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-01-05 |