| NPI | 1740669951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE THOMAS Registered Nurse 443-939-1138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 65085) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2015-05-20 |