NPI | 1255740767 |
---|---|
Entity Type | Organization |
Authorized Contact | LANAH W LARSON Secretary, Practice Administrator 904-264-6977 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Enumeration Date | 2014-08-08 |
Last Update Date | 2014-08-08 |