NPI | 1922470046 |
---|---|
Entity Type | Organization |
Authorized Contact | PAMELA LITTLE Owner 240-501-1336 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MD LC4282) |
Enumeration Date | 2015-10-28 |
Last Update Date | 2015-10-28 |