| NPI | 1730567272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK DANIEL President 410-948-6615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MD U00320) |
| Enumeration Date | 2015-05-17 |
| Last Update Date | 2015-05-17 |