| NPI | 1376634246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY L DAVIS Office Manager/ Med Asst 239-936-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2007-10-23 |