| NPI | 1366039505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS A. BROWN Owner 888-885-2336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 174400000X Specialist | |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2020-12-22 |