| NPI | 1730153974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOBIAS EDWARD JONES Facility Administrator 410-247-4741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MD A1329) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2008-02-21 |