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Organization

MYPOTENTIAL CLINIC - ROCKVILLE LLC

Active
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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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