| NPI | 1265152003 |
|---|---|
| Doing Business As | MILLENNIUM MEDICAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | JUSTIN DANIEL WIESNER Practice Director 424-285-5385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2022-10-20 |