| NPI | 1760209142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLMAN EJERENWA Owner 301-536-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2024-09-25 |
| Last Update Date | 2024-09-25 |