| NPI | 1265446512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY ALLEN BALSTER President 937-299-1918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 35051153) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: OH 35051153) |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: OH 35051153) | |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2011-05-19 |