| NPI | 1710658281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY HALLMAN President 443-519-8605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 111N00000X Chiropractor |
| 225100000X Physical Therapist | |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2021-09-24 |