| NPI | 1922404243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS E HENDERSON Owner 443-804-6723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME120324) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2018-03-17 |