| NPI | 1710980081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL TAYLOR LIVENGOOD Owner 301-722-3111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 171W00000X Contractor |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2023-03-21 |