Ethos Health Maryland 4, LLC
NPI #1912542192 in Glen Burnie, Maryland
Provider Information
- NPI Number
- 1912542192
- Entity Type
- Organization
- Organization Name
- Ethos Health Maryland 4, LLC
- Primary Specialty
- Clinic/Center - Health Service
- Enumeration Date
- Nov 12, 2019
- Last Updated
- Oct 13, 2021
Practice Location
- Address
- 1411 MADISON PARK DR
- City
- Glen Burnie
- State
- Maryland
- ZIP Code
- 21061-6185
- Phone
- (352) 732-5590
Authorized Official
- Name
- JONATHAN RAY WALKER, DC
- Title
- OWNER
- Phone
- (352) 732-5590
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Health Service — Health Service |
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