| NPI | 1114213998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH LOGAN Owner/Provider 704-541-1213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 9800612) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2011-09-08 |