Organization
MYPOTENTIAL CLINIC - ROCKVILLE LLC
Active
Parent organization
NATIONAL LUTHERAN INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NATIONAL LUTHERAN INC
Authorized official
RICHARD M MAZZA (CHIEF FINANCIAL OFFICER)
(301) 354-2710
Entity
Organization
Contact information
Practice address
9701 VEIRS DR, ROCKVILLE, MD 20850-3414
(301) 424-9560
Mailing address
2301 RESEARCH BLVD, SUITE 310, ROCKVILLE, MD 20850-3204
(301) 354-2710
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/24/2017
Last updated
07/11/2018
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