| NPI | 1598778623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON E. FULTCHER Clinic Administrator 410-636-7506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1101X Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2020-08-22 |