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Organization

BT RESTORATION & HEALING CENTER INJ LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROLE TCHATCHOUA CRNP-FAMILY (PRESIDENT)
(240) 422-7774
Entity
Organization

Contact information

Practice address
1140 OPAL CT, HAGERSTOWN, MD 21740-5940
(240) 422-7774
Mailing address
1140 OPAL CT, HAGERSTOWN, MD 21740-5940
(240) 422-7774

Taxonomy

Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
363LA2200X
Adult Health Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
04/12/2022
Last updated
07/13/2023
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