| NPI | 1508166752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS ALAN BOSTAPH President / Owner 240-522-8250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MD R087737) |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2016-02-19 |