| NPI | 1932781689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY PAUL Credentialing Coordinator 410-970-8190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2021-04-22 |