| NPI | 1477561801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHE A BRYANT Office Manager 410-327-6503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: MD 12773) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2012-01-25 |