| NPI | 1760491666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE GOODING Credentialing Representative 301-662-8541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2009-05-05 |