| NPI | 1982228045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIEL SHARIEF HAFIZ Managing Employee W 2 410-227-4939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261QM2500X Clinic/Center Medical Specialty | |
| 261QP2000X Clinic/Center Physical Therapy | |
| 261QR0400X Clinic/Center Rehabilitation | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| 111N00000X Chiropractor | |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2023-02-12 |