| NPI | 1104863042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD BOEHME President 904-249-4456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME62533) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2012-01-24 |