| NPI | 1578139291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A. DORN Owner 443-552-5552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 111N00000X Chiropractor |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QP3300X Clinic/Center, Pain | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2021-06-02 |