| NPI | 1447501473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS RUSSELL OLMSTED Owner 276-628-4926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101237200) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-30 |