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Individual

ELVIS Y CHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
HHA

Contact information

Practice address
13141 LARCHDALE RD, LAUREL, MD 20708-1724
(240) 481-1867
Mailing address
13141 LARCHDALE RD, LAUREL, MD 20708
(240) 481-1867

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
171M00000X
MD

Other

Enumeration date
06/07/2012
Last updated
06/07/2012
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