| NPI | 1629592472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMEAN FREAS CEO 410-571-2946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 208VP0000X Pain Medicine Pain Medicine | |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2023-04-13 |