| NPI | 1144779380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIEANN BISHOP Co Owner 346-221-1597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2016-09-29 |