| NPI | 1679268908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK E INGRAM CEO 443-540-2294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2023-04-11 |