| NPI | 1851748297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK SMITH Head Athletic Trainer 410-259-8548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MD A0000845) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-05-16 |