| NPI | 1760491633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY L IDOL Director 301-934-3345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: MD A1325R) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2020-08-22 |