| NPI | 1124458013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MICHAEL MONTANI Owner 618-334-5256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 110678) |
| Enumeration Date | 2013-11-14 |
| Last Update Date | 2013-11-14 |