| NPI | 1568005056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID S GRAHAM Owner 443-902-8816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| 261QP2300X Clinic/Center, Primary Care | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2024-07-01 |