| NPI | 1376783811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENELOPE EDWARDS-CONRAD Owner 229-244-1192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA GA45205) |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2009-05-08 |