| NPI | 1336696202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYCE NEUMANN Regional Manager 855-998-8467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2016-11-01 |