| NPI | 1083803357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH C LA MANCUSA Owner 419-425-5481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35057437) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2007-10-23 |