| NPI | 1306976717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK W RUSSELL President 574-522-7624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: IN 02001219) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2008-05-05 |