NPI | 1265601041 |
---|---|
Doing Business As | FORT WAYNE NEUROLOGICAL CENTER |
Entity Type | Organization |
Authorized Contact | DONALD RAY SHOOK CEO 260-399-4704 |
Organization Subpart ? | No |
Primary Taxonomy | 207T00000X Neurological Surgery |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
2084N0400X Psychiatry & Neurology, Neurology | |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2008-02-26 |
Last Update Date | 2019-10-17 |