Organization
GLENSAN WELLNESS AND LASER PAIN CENTER
Active
Organization
GLENSAN WELLNESS AND LASER PAIN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOSUNMOLA LAKE (MANAGER)
(301) 263-4890
Entity
Organization
Contact information
Practice address
216 CRAIN HWY N STE 103, GLEN BURNIE, MD 21061-3079
(301) 272-1558
Mailing address
10801 GREEN ASH LN, BELTSVILLE, MD 20705-3851
(301) 263-4890
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
07/12/2024
Last updated
07/12/2024
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