Organization
BRA-LA-LA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JORDAN (OWNER)
(301) 776-6007
Entity
Organization
Contact information
Practice address
8180 MAPLE LAWN BLVD, SUITE B, FULTON, MD 20759-2524
(301) 776-6007
(301) 776-6678
Mailing address
8180 MAPLE LAWN BLVD, SUITE B, FULTON, MD 20759-2524
(301) 776-6007
(301) 776-6678
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/03/2008
Last updated
10/03/2008
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