| NPI | 1063897668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE ROSE ANSELL Sole Proprietor 931-905-4144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 41086) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: TN 41086) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: TN 41086) | |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2015-07-23 |