| NPI | 1992242739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRONE ALONZO CHAPMAN Billing & Revenue Mgr. 443-739-3253 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: MD 1922340975) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2023-11-08 |