| NPI | 1063505956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MICHAEL HICKEY Owner 419-690-8273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35083960M) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-07-06 |