| Ethos Health Group Maryland 5 Llc | |
|
152 Rollins Ave Ste 210 Rockville MD 20852-4008 | |
| (352) 732-5590 | |
| (352) 732-0292 |
| Full Name | Ethos Health Group Maryland 5 Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 152 Rollins Ave Ste 210, Rockville, Maryland |
| Authorized Official Name and Position | Jonathan Ray Walker (OWNER/OPERATOR) |
| Authorized Official Contact | 3527325590 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ethos Health Group Maryland 5 Llc 152 Rollins Ave Ste 210 Rockville MD 20852-4008 Ph: (352) 732-5590 | Ethos Health Group Maryland 5 Llc 152 Rollins Ave Ste 210 Rockville MD 20852-4008 Ph: (352) 732-5590 |
| NPI Number | 1164094652 |
|---|---|
| Provider Enumeration Date | 07/14/2021 |
| Last Update Date | 07/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164094652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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