Individual
JAE-WOO IM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
8925 TAWES ST, FULTON, MD 20759-2582
(240) 997-0326
(410) 928-4907
Mailing address
8925 TAWES ST, FULTON, MD 20759-2582
(240) 997-0326
(410) 928-4907
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
05416
MD
Other
Enumeration date
01/06/2010
Last updated
02/10/2014
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