Ethos Health Group Maryland 5 LLC
Clinic/Center, Multi-Specialty in Rockville, MD. Organization (NPI-2).
NPI number1164094652
StatusActive
Last updated in NPPESJul 14, 2021
Details
- NPI
- 1164094652
- Entity type
- Organization (NPI-2)
- Legal business name
- Ethos Health Group Maryland 5 LLC
- Organization subpart
- No
- Enumeration date
- Jul 14, 2021
- Certification date
- Jul 14, 2021
- Last updated
- Jul 14, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | Yes |
Practice location
152 Rollins Ave Ste 210Rockville, MD 20852-4008
Phone 352-732-5590 · Fax 352-732-0292
Mailing address
152 Rollins Ave Ste 210Rockville, MD 20852-4008
Phone 352-732-5590 · Fax 352-732-0292
Authorized official
Jonathan Ray Walker
Owner/Operator
3527325590
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