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124 Camp 4 Rd Swanton MD 21561-1329 | |
(301) 359-9190 | |
(301) 359-0811 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 124 Camp 4 Rd, Swanton, Maryland |
Authorized Official Name and Position | Tammy Lynn Fisher (ADMINISTRATOR-CLINICAL SUPERVISOR) |
Authorized Official Contact | 3013599190 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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124 Camp 4 Rd Swanton MD 21561-1329 Ph: (301) 359-9190 | 124 Camp 4 Rd Swanton MD 21561-1329 Ph: (301) 359-9190 |
NPI Number | 1861612897 |
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Provider Enumeration Date | 05/01/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1861612897 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |