Organization
KETAMINE HEALTH & RESTORATION, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY OWENS MD (OWNER)
(301) 298-8267
Entity
Organization
Contact information
Practice address
585 MAIN ST STE 145, LAUREL, MD 20707-4354
(301) 298-8267
(301) 517-9386
Mailing address
585 MAIN ST STE 145, LAUREL, MD 20707-4354
(301) 298-8267
(301) 517-9386
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
09/13/2023
Last updated
05/17/2024
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