| NPI | 1821666967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY VANDEMAN Owner 301-455-1348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207R00000X Internal Medicine | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2021-11-17 |