| NPI | 1386979375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANDI RENEE REA Credentialing Specialists 606-330-3404 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2009-10-08 |