| State Of The Body Llc | |
|
1133 Wedgewood Rd Baltimore MD 21229-1247 | |
| (919) 880-8115 | |
| Not Available |
| Full Name | State Of The Body Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1133 Wedgewood Rd, Baltimore, Maryland |
| Authorized Official Name and Position | Eboni Mccoy (PRESIDENT) |
| Authorized Official Contact | 9198808115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State Of The Body Llc 1133 Wedgewood Rd Baltimore MD 21229-1247 Ph: (919) 880-8115 | State Of The Body Llc 1133 Wedgewood Rd Baltimore MD 21229-1247 Ph: (919) 880-8115 |
| NPI Number | 1194541292 |
|---|---|
| Provider Enumeration Date | 11/23/2024 |
| Last Update Date | 11/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194541292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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