| NPI | 1487191375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRONE ALONZO CHAPMAN Billing & Revenue Mgr. 443-739-3253 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP0905X Clinic/Center Public Health, State or Local |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2023-11-08 |