| NPI | 1073109542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT A LOGAN Owner 603-601-7762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2021-06-22 |