NPI | 1396080156 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN ORVIL COLLINS President 260-267-6142 |
Organization Subpart ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01070620A) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: IN 20042429A) |
363L00000X Nurse Practitioner (Licence: IN 71002635A) | |
Enumeration Date | 2012-12-05 |
Last Update Date | 2019-10-21 |