| NPI | 1639223381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED STEWART GOLDSTEIN Owner 301-262-5852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports |
| 2251X0800X Physical Therapist Orthopedic | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2008-12-19 |