Organization
BMOREYOUTHFUL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN WEST (PROVIDER)
(443) 902-1364
Entity
Organization
Contact information
Practice address
517 DUSK VIEW DR, HAVRE DE GRACE, MD 21078-2369
(443) 902-1364
Mailing address
517 DUSK VIEW DR, HAVRE DE GRACE, MD 21078-2369
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
04/06/2020
Last updated
04/06/2020
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