| NPI | 1487806386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK A MARTIN Owner/President 301-367-7797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 18131) |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2008-10-22 |