| NPI | 1508380627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA DELOACH Credentialing 410-821-7775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2017-07-31 |