| NPI | 1104058874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EARL B MALLY Senior Vice President 904-376-4275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2010-06-25 |